Provider Demographics
NPI:1801841978
Name:SOTO, ELIANA AMPARO (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIANA
Middle Name:AMPARO
Last Name:SOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 LOYOLA AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70113-9521
Mailing Address - Country:US
Mailing Address - Phone:504-558-9595
Mailing Address - Fax:
Practice Address - Street 1:1057 PAUL MAILLARD ROAD
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070
Practice Address - Country:US
Practice Address - Phone:985-785-2218
Practice Address - Fax:985-785-7753
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1035122Medicaid
LA201700OtherSTATE MEDICAL BOARD
LA201700OtherSTATE MEDICAL BOARD