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NPI Code Detail

MEDICARE: RODOLFO P SOTOLONGO MD

MEDICARE: RODOLFO P SOTOLONGO MD
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
1207RC0000XCardiovascular Disease PhysicianG4209TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255376679
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODOLFO P SOTOLONGO MD
Provider Business Mailing Address
First Line : P.O. BOX 7410
Second Line :
City : BEAUMONT
State : TX
Zip : 77726-7410
Country : US
Telephone Number : 409-835-5508
Fax Number : 409-835-3835
Provider Business Practice Location Address
First Line : 2693 NORTH ST
Second Line :
City : BEAUMONT
State : TX
Zip : 77702-1624
Country : US
Telephone Number : 409-832-8862
Fax Number : 409-832-1664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 05/29/2014

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Directions to “ RODOLFO P SOTOLONGO MD” Practice Location

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