MEDICARE: DR. RAUL SOTO-ACOSTA 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	2084P0800X	Psychiatry Physician	ME69974	FL

General Provider Information

NPI Number	:	1619991106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAUL SOTO-ACOSTA M.D.

Provider Business Mailing Address
First Line	:	3547 HENDRICKS AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5309
Country	:	US
Telephone Number	:	904-877-1100
Fax Number	:	904-877-1200

Provider Business Practice Location Address
First Line	:	3547 HENDRICKS AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5309
Country	:	US
Telephone Number	:	904-877-1100
Fax Number	:	904-733-5258

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	11/19/2025

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