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General NPI Number Information
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NPI Number | 1255406195
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Entity Type | Individual
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Provider Name | IVAN E. SOTO RPH
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Gender | Male
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5850 NW 183RD ST
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City | HIALEAH
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State | FL
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Zip | 33015-6023
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Country | US
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Telephone | 305-819-0705
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Fax | 305-819-0174
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Provider Business Mailing Address
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Address Line | 5479 NW 184TH ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-5344
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Country | US
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Telephone | 305-624-7651
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Fax | 305-819-0174
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS28399
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License Number State | FL
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