Healthcare Provider Details

I. General information

NPI: 1811540206
Provider Name (Legal Business Name): CORALYS SOTO RODRIGUEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB CAMINO DEL SOL II 73 AVE METEORO
MANATI PR
00674
US

IV. Provider business mailing address

73 AVE METEORO
MANATI PR
00674-4878
US

V. Phone/Fax

Practice location:
  • Phone: 787-549-5059
  • Fax:
Mailing address:
  • Phone: 787-242-9586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number022801
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number022801
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: