Healthcare Provider Details

I. General information

NPI: 1407560642
Provider Name (Legal Business Name): ROBYN NICOLE SOTO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9981 S HEALTHPARK DR
FORT MYERS FL
33908-3618
US

IV. Provider business mailing address

2601 22ND ST W
LEHIGH ACRES FL
33971-0543
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-6900
  • Fax:
Mailing address:
  • Phone: 239-227-5969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number9509394
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11026449
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: