Provider Demographics
NPI:1265071237
Name:HERNANDEZ SOTO, YELITZA
Entity type:Individual
Prefix:DR
First Name:YELITZA
Middle Name:
Last Name:HERNANDEZ 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:HC 1 BOX 6051
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-9071
Mailing Address - Country:US
Mailing Address - Phone:787-413-4336
Mailing Address - Fax:
Practice Address - Street 1:CARR. 420 KM 2.2
Practice Address - Street 2:BO. VOLADORAS
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-413-4336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006645183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist