Provider Demographics
NPI:1891934246
Name:SOTO, LAURA ELENA (DO)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ELENA
Last Name:SOTO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 NW 42ND AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5683
Mailing Address - Country:US
Mailing Address - Phone:305-858-1944
Mailing Address - Fax:305-444-7342
Practice Address - Street 1:351 NW 42ND AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5683
Practice Address - Country:US
Practice Address - Phone:305-858-1944
Practice Address - Fax:305-444-7342
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine