Healthcare Provider Details

I. General information

NPI: 1447211347
Provider Name (Legal Business Name): GILBERTO OLIVERAS SOTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSP SAN FRANCISCO AVE D DE DIEGO 371
RIO PIEDRAS PR
00918
US

IV. Provider business mailing address

PO BOX 71325
SAN JUAN PR
00936-8425
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-0102
  • Fax: 787-767-1899
Mailing address:
  • Phone: 787-767-0102
  • Fax: 787-769-2062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number9387
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: