MEDICARE: YUDERSI SOTO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11037503	FL

General Provider Information

NPI Number	:	1134009632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUDERSI SOTO

Provider Business Mailing Address
First Line	:	15525 SW 138TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-1178
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15525 SW 138TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-1178
Country	:	US
Telephone Number	:	786-302-2403
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2025
Last Update Date	:	09/04/2025

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Directions to “ YUDERSI SOTO ” Practice Location

Language	Start Address	Practice Location

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