Provider Demographics
NPI:1952725368
Name:APONTE - SOTO, MICHELL (PH D)
Entity type:Individual
Prefix:DR
First Name:MICHELL
Middle Name:
Last Name:APONTE - SOTO
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 CALLE LAGO CARRAIZO
Mailing Address - Street 2:VISTALAGO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-2377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:59 CALLE LAGO CARRAIZO
Practice Address - Street 2:VISTALAGO
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-9107
Practice Address - Country:US
Practice Address - Phone:787-565-7585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5382103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist