=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790953875
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAEL BERNIER-SOTO M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2008
-----------------------------------------------------
Last Update Date | 02/12/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PLAZA OASIS CARR. 153 EDIFICIO D-6
-----------------------------------------------------
City | SANTA ISABEL
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-845-3000
-----------------------------------------------------
Fax | 787-845-8800
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 3000 SUITE 510
-----------------------------------------------------
City | COAMO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00769-6000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-845-3000
-----------------------------------------------------
Fax | 787-845-8800
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | 11713
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------