Provider Demographics
NPI:1023419306
Name:SOTO, ADA E
Entity type:Individual
Prefix:
First Name:ADA
Middle Name:E
Last Name:SOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BLVD MEDIA LUNA
Mailing Address - Street 2:APT.1701
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-5216
Mailing Address - Country:US
Mailing Address - Phone:787-923-4486
Mailing Address - Fax:
Practice Address - Street 1:15 BLVD MEDIA LUNA
Practice Address - Street 2:APT.1701
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-5216
Practice Address - Country:US
Practice Address - Phone:787-923-4486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR679225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist