Healthcare Provider Details

I. General information

NPI: 1134050008
Provider Name (Legal Business Name): KRISTOPHER ALEXIS SOTO AQUINO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URBANIZACION PONCE DE LEON 23 CALLE 19
GUAYNABO PR
00969
US

IV. Provider business mailing address

URBANIZACION PONCE DE LEON 23 CALLE 19
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 939-717-5997
  • Fax: 939-717-5997
Mailing address:
  • Phone: 939-717-5997
  • Fax: 939-717-5997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number85554
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number85554
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number85554
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: