Healthcare Provider Details

I. General information

NPI: 1720528896
Provider Name (Legal Business Name): MISS YANIRA SOTO TORRES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 CALLE GUADALUPE
PONCE PR
00730-3561
US

IV. Provider business mailing address

PO BOX 560970
GUAYANILLA PR
00656-3970
US

V. Phone/Fax

Practice location:
  • Phone: 787-704-0705
  • Fax: 787-744-7444
Mailing address:
  • Phone: 787-704-0705
  • Fax: 787-744-7444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number7200
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: