Provider Demographics
NPI:1184959025
Name:SOTO AVILES, WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:SOTO AVILES
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 1:611 CALLE EZEQUIEL # G-27
Mailing Address - Street 2:URB.BRISAS DEL CAMPANERO
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-2235
Mailing Address - Country:US
Mailing Address - Phone:787-315-2219
Mailing Address - Fax:
Practice Address - Street 1:611 CALLE EZEQUIEL # G-27
Practice Address - Street 2:URB.BRISAS DEL CAMPANERO
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-2235
Practice Address - Country:US
Practice Address - Phone:787-315-2219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17746208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice