MEDICARE: DR. JULIO CESAR SOTO JR. 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
1	207Q00000X	Family Medicine Physician	35096156	OH
2	207Q00000X	Family Medicine Physician	TM209	GA
3	207Q00000X	Family Medicine Physician	042.0017894-COMP	VT
4	207Q00000X	Family Medicine Physician	V1990	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1689883860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIO CESAR SOTO JR. MD

Provider Business Mailing Address
First Line	:	3170 KETTERING BLVD BLDG B3
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1924
Country	:	US
Telephone Number	:	937-991-3188
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 S STANFIELD RD STE 306
Second Line	:
City	:	TROY
State	:	OH
Zip	:	45373
Country	:	US
Telephone Number	:	937-440-7655
Fax Number	:

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	03/11/2026

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