Provider Demographics
NPI:1912094558
Name:SOTOMAYOR, CARLOS E (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:SOTOMAYOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:E
Other - Last Name:SOTOMAYOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1626 CALLE TIGRIS
Mailing Address - Street 2:URB RIO PIEDRAS HEIGHTS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-2942
Mailing Address - Country:US
Mailing Address - Phone:787-733-2330
Mailing Address - Fax:787-733-4235
Practice Address - Street 1:1626 CALLE TIGRIS
Practice Address - Street 2:URB RIO PIEDRAS HEIGHTS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-2942
Practice Address - Country:US
Practice Address - Phone:787-733-2330
Practice Address - Fax:787-733-4235
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6658174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist