Provider Demographics
NPI:1134863921
Name:SOTO LEON, DANILO ENRIQUE (APRN)
Entity type:Individual
Prefix:
First Name:DANILO
Middle Name:ENRIQUE
Last Name:SOTO LEON
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5263 NEIL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-2403
Mailing Address - Country:US
Mailing Address - Phone:305-497-5442
Mailing Address - Fax:
Practice Address - Street 1:14438 UNIVERSITY COVE PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3740
Practice Address - Country:US
Practice Address - Phone:813-739-7497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037116164W00000X, 363L00000X
PR1239363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant