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NPI Code Detail

MEDICARE: DR. JOSE GABRIEL SOTO

MEDICARE:  DR. JOSE GABRIEL SOTO
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
1103TC0700XClinical Psychologist8049PR

General Provider Information

NPI Number : 1629807524
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE GABRIEL SOTO
Provider Business Mailing Address
First Line : PO BOX 970
Second Line :
City : CAMUY
State : PR
Zip : 00627-0970
Country : US
Telephone Number : 787-517-4928
Fax Number :
Provider Business Practice Location Address
First Line : PO BOX 2100
Second Line :
City : SAN JUAN
State : PR
Zip : 00922-2100
Country : US
Telephone Number : 787-766-4646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2024
Last Update Date : 07/29/2024

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Directions to “ DR. JOSE GABRIEL SOTO ” Practice Location

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