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General NPI Number Information
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NPI Number | 1295933448
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Entity Type | Individual
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Provider Name | SOTERO PERALTA M.D
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Gender | Male
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 3310 WATERMAN WAY
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City | TAVARES
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State | FL
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Zip | 32778-5250
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Country | US
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Telephone | 352-385-3022
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Fax | 352-385-3023
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Provider Business Mailing Address
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Address Line | 3310 WATERMAN WAY
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City | TAVARES
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State | FL
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Zip | 32778-5250
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Country | US
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Telephone | 352-385-3022
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Fax | 352-385-3023
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 35.096964
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | S3565
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | ME138301
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License Number State | FL
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