Provider Demographics
NPI:1013287192
Name:SOTO, REYNALDO (MD)
Entity Type:Individual
Prefix:DR
First Name:REYNALDO
Middle Name:
Last Name:SOTO
Suffix:
Gender:M
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:HACIENDA DEL GOLF Y PLAYA #87
Mailing Address - Street 2:POBOX 949
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0949
Mailing Address - Country:US
Mailing Address - Phone:787-365-7417
Mailing Address - Fax:
Practice Address - Street 1:55 CALLE PALMA
Practice Address - Street 2:201
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4526
Practice Address - Country:US
Practice Address - Phone:787-880-3469
Practice Address - Fax:787-878-2072
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11984146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant