Provider Demographics
NPI:1205972437
Name:SOTO, JULIO MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:MICHAEL
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:M6 CALLE PATIO HL
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-3145
Mailing Address - Country:US
Mailing Address - Phone:787-781-7610
Mailing Address - Fax:787-781-7610
Practice Address - Street 1:525 AVE FD ROOSEVELT
Practice Address - Street 2:PLAZA LAS AMERICA TOWER 612
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8001
Practice Address - Country:US
Practice Address - Phone:787-781-7610
Practice Address - Fax:787-781-7610
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10047174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist