MEDICARE: DR. ROBERTO JOSE RIVERO SOTO MD

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	208600000X	Surgery Physician	102850	GA

General Provider Information

NPI Number	:	1609364678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERTO JOSE RIVERO SOTO MD

Provider Business Mailing Address
First Line	:	517 CONCORD AVE APT 2
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-4507
Country	:	US
Telephone Number	:	914-564-9750
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 E 149TH ST STE 620
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451
Country	:	US
Telephone Number	:	718-579-5900
Fax Number	:	718-579-4620

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

Provider Enumeration Date	:	04/25/2018
Last Update Date	:	03/09/2026

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