Provider Demographics
NPI:1790197846
Name:SOTO, LESLIE ANN (MD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:SOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3901 COCONUT PALM DR
Mailing Address - Street 2:STE 120
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619
Mailing Address - Country:US
Mailing Address - Phone:407-266-1106
Mailing Address - Fax:844-587-4802
Practice Address - Street 1:6850 LAKE NONA BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7408
Practice Address - Country:US
Practice Address - Phone:407-266-1106
Practice Address - Fax:407-266-1199
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME132168208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist