Healthcare Provider Details

I. General information

NPI: 1922084045
Provider Name (Legal Business Name): JOSE J. SOTO SOLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

# 2 CALLE LUIS MUNOZ RIVERA SUITE 204
CAGUAS PR
00725
US

IV. Provider business mailing address

PO BOX 1183
CAGUAS PR
00726-1183
US

V. Phone/Fax

Practice location:
  • Phone: 787-744-3121
  • Fax:
Mailing address:
  • Phone: 787-744-3121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number2836
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: