Provider Demographics
NPI:1477829463
Name:SOTO, LUIS NOEL (BSPH)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:NOEL
Last Name:SOTO
Suffix:
Gender:M
Credentials:BSPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 AVE WINSTON CHURCHILL
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6064
Mailing Address - Country:US
Mailing Address - Phone:787-296-1616
Mailing Address - Fax:787-296-2626
Practice Address - Street 1:124 AVE WINSTON CHURCHILL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6064
Practice Address - Country:US
Practice Address - Phone:787-296-1616
Practice Address - Fax:787-296-2626
Is Sole Proprietor?:No
Enumeration Date:2012-03-24
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1707183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy