MEDICARE: MR. ELVIN SOTO-HERNANDEZ MSW

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	1041C0700X	Clinical Social Worker	10453	PR
2	103TC0700X	Clinical Psychologist	8581	PR

General Provider Information

NPI Number	:	1689983496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ELVIN SOTO-HERNANDEZ MSW

Provider Business Mailing Address
First Line	:	12012 CALLE GUAJANA
Second Line	:	URB. ESTANCIAS DEL MAYORAL
City	:	VILLALBA
State	:	PR
Zip	:	00766-2430
Country	:	US
Telephone Number	:	939-630-0860
Fax Number	:

Provider Business Practice Location Address
First Line	:	12012 CALLE GUAJANA
Second Line	:	URB. ESTANCIAS DEL MAYORAL
City	:	VILLALBA
State	:	PR
Zip	:	00766-2430
Country	:	US
Telephone Number	:	939-630-0860
Fax Number	:

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

Provider Enumeration Date	:	09/28/2010
Last Update Date	:	07/15/2025

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