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NPI Code Detail

MEDICARE: ANTHONY NELSON SOTO 1532B

MEDICARE: ANTHONY NELSON SOTO 1532B
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
1363LF0000XFamily Nurse Practitioner11043155FL
2163W00000XRegistered Nurse9532827FL

General Provider Information

NPI Number : 1174737944
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY NELSON SOTO 1532B
Provider Business Mailing Address
First Line : 819 ASSEMBLY CT
Second Line :
City : REUNION
State : FL
Zip : 34747-6760
Country : US
Telephone Number : 786-817-7861
Fax Number :
Provider Business Practice Location Address
First Line : 7950 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-8229
Country : US
Telephone Number : 407-658-2046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 02/10/2026

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