Healthcare Provider Details

I. General information

NPI: 1295755429
Provider Name (Legal Business Name): ROBERTO FRANCISCO SOTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 EXECUTIVE BLVD SUITE 302
ROCKVILLE MD
20852-3803
US

IV. Provider business mailing address

6000 EXECUTIVE BLVD SUITE 302
ROCKVILLE MD
20852-3803
US

V. Phone/Fax

Practice location:
  • Phone: 301-656-7226
  • Fax: 301-656-7225
Mailing address:
  • Phone: 301-656-7226
  • Fax: 301-656-7225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0055575
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberD0055575
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: