Provider Demographics
NPI:1265191050
Name:SOTO CARDONA, CARLOS ENRIQUE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ENRIQUE
Last Name:SOTO CARDONA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 CALLE TAGORE PARQUES DE CUPEY
Mailing Address - Street 2:APT 1511
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-245-7615
Mailing Address - Fax:
Practice Address - Street 1:18 CALLE TAGORE PARQUES DE CUPEY
Practice Address - Street 2:APT 1511
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-245-7615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist