Healthcare Provider Details

I. General information

NPI: 1700934353
Provider Name (Legal Business Name): FERNANDO ALVAREZ-SOTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 GOYCO ST
CAGUAS PR
00725-0000
US

IV. Provider business mailing address

PO BOX 6149
CAGUAS PR
00726-6149
US

V. Phone/Fax

Practice location:
  • Phone: 787-746-2530
  • Fax: 787-746-2530
Mailing address:
  • Phone: 787-746-2530
  • Fax: 787-746-2530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6669
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: