Provider Demographics
NPI:1457742611
Name:SOTO ORTIZ, IRIS (LPN)
Entity Type:Individual
Prefix:MRS
First Name:IRIS
Middle Name:
Last Name:SOTO ORTIZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 645
Mailing Address - Street 2:EXT.VALLES DE ARROYO I-8
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-0645
Mailing Address - Country:US
Mailing Address - Phone:939-332-6770
Mailing Address - Fax:
Practice Address - Street 1:EXT VALLES DE ARROYO I-8
Practice Address - Street 2:
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-0645
Practice Address - Country:US
Practice Address - Phone:939-332-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33961164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR33961OtherLPN