Healthcare Provider Details

I. General information

NPI: 1568759223
Provider Name (Legal Business Name): JENNIFER SOTO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 07/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA MONTE REAL CARR 2 KM 45.8
MANATI PR
00674
US

IV. Provider business mailing address

PO BOX 480
HATILLO PR
00659-0480
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-0004
  • Fax:
Mailing address:
  • Phone: 787-503-3410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5496
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: