Provider Demographics
NPI:1740298710
Name:SOTO TORRES, FERNANDO L (MD)
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:L
Last Name:SOTO TORRES
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 1:65 INFANTERIA KM #8.3 HOSPITAL UPR
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-750-0930
Mailing Address - Fax:
Practice Address - Street 1:65 INFANTERIA KM #8.3 HOSPITAL UPR.
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-399-5313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15884207P00000X
NJ25MA08172800207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0136662Medicaid
P00416561Medicare PIN
PR2-3658Medicare ID - Type Unspecified
PRI-51148Medicare UPIN