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General NPI Number Information
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NPI Number | 1831480987
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Entity Type | Individual
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Provider Name | LUZ MERARY SOTO O.D.
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Gender | Female
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | TRUJILLO ALTO PLAZA LOT 22
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-710-1509
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Fax | 787-333-6171
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Provider Business Mailing Address
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Address Line | URB. RIVER GARDEN CALLE FLOR DIEGO # 195
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-644-4161
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 612
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License Number State | PR
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