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General NPI Number Information
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NPI Number | 1770402026
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Entity Type | Organization
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Legal Business Name | JORGE LUIS SOTELO, MD
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | TEL: 973.769.0765 FAX: 954.252.2259 MEMORIAL SYSTEM
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City | DEA # FC5079341
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State | LIC #: 89636
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Zip | NPI 1518538207
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Country | UM
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 3440 HOLLYWOOD BOULEVARD SUITE 360
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City | HOLLYWOOD
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State | FL
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Zip | 33021
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Country | UM
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MR. ALEXANDER JAMES MOTOLANEZ
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Credential |
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Telephone | 973-769-0765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 246ZG1000X
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Taxonomy Name | Medical Geneticist (PhD) Specialist/Technologist
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License Number |
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License Number State |
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