Healthcare Provider Details

I. General information

NPI: 1699989087
Provider Name (Legal Business Name): NOEL PEREZ SOTO PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MANSIONES TINTILLO HILLS 6 ST # 2
GUAYNABO PR
00907
US

IV. Provider business mailing address

MANSIONES TINTILLO HILLS 6 ST # 2
GUAYNABO PR
00907
US

V. Phone/Fax

Practice location:
  • Phone: 787-314-3544
  • Fax: 787-812-0565
Mailing address:
  • Phone: 787-314-3544
  • Fax: 787-812-0565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number12928
License Number StatePR

VIII. Authorized Official

Name: DR. NOEL PEREZ-SOTO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-314-3544