MEDICARE: DR. ROCHELLY MEDINA-SOTO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	15395	PR
2	2085U0001X	Diagnostic Ultrasound Physician	15395	PR

General Provider Information

NPI Number	:	1134106875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROCHELLY MEDINA-SOTO M.D.

Provider Business Mailing Address
First Line	:	400 ROOSEVELT AVE.
Second Line	:	CLINICA LAS AMERICAS SUITE 101
City	:	HATOREY
State	:	PR
Zip	:	00918-2129
Country	:	US
Telephone Number	:	787-765-7713
Fax Number	:	787-250-7967

Provider Business Practice Location Address
First Line	:	400 ROOSEVELT AVE.
Second Line	:	CLINICA LAS AMERICAS, SUITE 101
City	:	HATOREY
State	:	PR
Zip	:	00918-2129
Country	:	US
Telephone Number	:	787-765-7713
Fax Number	:	787-250-7967

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	01/02/2014

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Directions to “ DR. ROCHELLY MEDINA-SOTO M.D.” Practice Location

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