Provider Demographics
NPI:1891750386
Name:SOTO MALDONADO, SARANETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:SARANETTE
Middle Name:
Last Name:SOTO MALDONADO
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:PMB 215
Mailing Address - Street 2:PO BOX 4952
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4952
Mailing Address - Country:US
Mailing Address - Phone:787-719-6060
Mailing Address - Fax:787-719-6060
Practice Address - Street 1:60-A CALLE ANTONIO LOPEZ
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-719-6060
Practice Address - Fax:787-719-6060
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15035208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice