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General NPI Number Information
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NPI Number | 1003049990
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Entity Type | Individual
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Provider Name | ADELENE SOTO ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 930 MARCUM RD
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City | LAKELAND
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State | FL
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Zip | 33809-4308
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Country | US
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Telephone | 863-815-3775
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Fax | 863-815-3765
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Provider Business Mailing Address
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Address Line | 3372 TUMBLING RIVER DR
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City | CLERMONT
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State | FL
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Zip | 34711-8907
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Country | US
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Telephone | 407-467-5947
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP9229185
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License Number State | FL
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