Provider Demographics
NPI:1851589915
Name:JAIME A. SOTERAS MD PA
Entity Type:Organization
Organization Name:JAIME A. SOTERAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOTERAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-826-9565
Mailing Address - Street 1:4160 W 16TH AVE
Mailing Address - Street 2:# 203
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5853
Mailing Address - Country:US
Mailing Address - Phone:305-826-9565
Mailing Address - Fax:305-826-9565
Practice Address - Street 1:4160 W 16TH AVE
Practice Address - Street 2:# 203
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5853
Practice Address - Country:US
Practice Address - Phone:305-826-9565
Practice Address - Fax:305-826-9565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0068506208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9380Medicare PIN