Provider Demographics
NPI:1952481749
Name:SOTO ORTIZ, CARMEN I (DPT)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:I
Last Name:SOTO ORTIZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 79
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715-0079
Mailing Address - Country:US
Mailing Address - Phone:787-602-9785
Mailing Address - Fax:
Practice Address - Street 1:232 CALLE CIPRES
Practice Address - Street 2:ESTANCIAS DE JUANA DIAZ
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-2841
Practice Address - Country:US
Practice Address - Phone:787-602-9785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1017225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist