Provider Demographics
NPI:1831480987
Name:SOTO, LUZ MERARY (OD)
Entity Type:Individual
Prefix:DR
First Name:LUZ
Middle Name:MERARY
Last Name:SOTO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. RIVER GARDEN CALLE FLOR DIEGO
Mailing Address - Street 2:# 195
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729
Mailing Address - Country:US
Mailing Address - Phone:787-644-4161
Mailing Address - Fax:
Practice Address - Street 1:TRUJILLO ALTO PLAZA LOT 22
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-710-1509
Practice Address - Fax:787-333-6171
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR612152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist