Provider Demographics
NPI:1952663734
Name:SOTO, LIZBETH (LMT)
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10742 PALAISEAU CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7193
Mailing Address - Country:US
Mailing Address - Phone:407-928-6102
Mailing Address - Fax:407-601-4902
Practice Address - Street 1:5740 OLD CHENEY HWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3525
Practice Address - Country:US
Practice Address - Phone:407-928-6102
Practice Address - Fax:407-601-4902
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA61102225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist