Provider Demographics
NPI:1982472494
Name:SOTO, MARIA DEL CARMEN
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:SOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29757 SPRINGTIME RD
Mailing Address - Street 2:
Mailing Address - City:BIG PINE KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33043-3147
Mailing Address - Country:US
Mailing Address - Phone:786-806-8400
Mailing Address - Fax:
Practice Address - Street 1:29757 SPRINGTIME RD
Practice Address - Street 2:
Practice Address - City:BIG PINE KEY
Practice Address - State:FL
Practice Address - Zip Code:33043-3147
Practice Address - Country:US
Practice Address - Phone:786-806-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL538530106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst