Healthcare Provider Details

I. General information

NPI: 1164560058
Provider Name (Legal Business Name): DANILO HUMBERTO SOTELO-GARZA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 08/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 3RD AVE APT.2058
BRONX NY
10454-1199
US

IV. Provider business mailing address

33 HUDSON ST APT. 2106
JERSEY CITY NJ
07302-6575
US

V. Phone/Fax

Practice location:
  • Phone: 718-292-0100
  • Fax: 718-866-0163
Mailing address:
  • Phone: 520-909-1724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number136353
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: