=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689625626
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OSCAR A SOTO MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2006
-----------------------------------------------------
Last Update Date | 10/15/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4800 N FEDERAL HWY STE 200
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33308-4611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-771-2111
-----------------------------------------------------
Fax | 954-771-7347
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4800 N FEDERAL HWY STE 200
-----------------------------------------------------
City | FORT LAUDERDALE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33308-4611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-771-2111
-----------------------------------------------------
Fax | 954-771-7347
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. OSCAR A SOTO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 954-771-2111
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | ME14780
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------