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NPI Code Detail

MEDICARE: RAFAEL HUMBERTO PEREZ SOTO MD

MEDICARE: RAFAEL HUMBERTO PEREZ SOTO 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
1208600000XSurgery PhysicianAPP-000760719OH

General Provider Information

NPI Number : 1730933714
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAFAEL HUMBERTO PEREZ SOTO MD
Provider Business Mailing Address
First Line : 1906 E 84TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44103-4225
Country : US
Telephone Number : 554-191-3281
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0002
Country : US
Telephone Number : 554-191-3281
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2024
Last Update Date : 04/15/2024

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