Healthcare Provider Details

I. General information

NPI: 1598950990
Provider Name (Legal Business Name): ELIEZER SOTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2007
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 37TH ST STE C101
VERO BEACH FL
32960-7301
US

IV. Provider business mailing address

6700 INDIAN CREEK DR APT1502
MIAMI BEACH FL
33141-5780
US

V. Phone/Fax

Practice location:
  • Phone: 772-360-1997
  • Fax: 772-492-3571
Mailing address:
  • Phone: 954-720-3188
  • Fax: 954-586-2589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME159083
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME159083
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberME159083
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME159083
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: