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NPI Code Detail

MEDICARE: DR ANITA M SOTO O.D. INC.

MEDICARE: DR ANITA M SOTO O.D. INC.
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
1152W00000XOptometrist4850 T1715OH

General Provider Information

NPI Number : 1578847018
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR ANITA M SOTO O.D. INC.
Provider Business Mailing Address
First Line : 6785 WALLINGS RD
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-3024
Country : US
Telephone Number : 440-237-9120
Fax Number : 440-237-9124
Provider Business Practice Location Address
First Line : 6785 WALLINGS RD
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-3024
Country : US
Telephone Number : 440-237-9120
Fax Number : 440-237-9124
Authorized Official
Title or Position : PHYSICIAN
Name : ANITA SOTO
Credential : OD
Telephone Number : 440-237-9120
Provider Enumeration Date : 10/03/2011
Last Update Date : 10/03/2011

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