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NPI Code Detail

MEDICARE: DR. CARLOS M SOTOLONGO MD

MEDICARE: DR. CARLOS M SOTOLONGO 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
1207RC0000XCardiovascular Disease PhysicianME70357FL
2207UN0901XNuclear Cardiology PhysicianME70357FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00188533OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639171044
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARLOS M SOTOLONGO MD
Provider Business Mailing Address
First Line : PO BOX 746652
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6652
Country : US
Telephone Number : 904-202-2092
Fax Number : 904-376-4075
Provider Business Practice Location Address
First Line : 1320 ROBERTS DR STE 101
Second Line :
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3253
Country : US
Telephone Number : 904-241-7147
Fax Number : 904-376-3213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 01/02/2026

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Directions to “ DR. CARLOS M SOTOLONGO MD” Practice Location

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