Provider Demographics
NPI:1952851982
Name:SOTOCHIROSTUDIO
Entity Type:Organization
Organization Name:SOTOCHIROSTUDIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-480-9147
Mailing Address - Street 1:200 ALLAMANDA DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-2928
Mailing Address - Country:US
Mailing Address - Phone:863-682-4182
Mailing Address - Fax:
Practice Address - Street 1:200 ALLAMANDA DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2928
Practice Address - Country:US
Practice Address - Phone:863-682-4182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty