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NPI Code Detail

MEDICARE: AMANDA RAQUEL SOTO PEREZ

MEDICARE: AMANDA RAQUEL SOTO PEREZ
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
1390200000XStudent in an Organized Health Care Education/Training Program
2208000000XPediatrics Physician125.084715IL

General Provider Information

NPI Number : 1881374304
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA RAQUEL SOTO PEREZ
Provider Business Mailing Address
First Line : 3600 FORBES AVENUE
Second Line : FORBES TOWER - PLAZA LEVEL SUITE 140
City : PITTSBURGH
State : PA
Zip : 15213
Country : US
Telephone Number : 773-702-1150
Fax Number :
Provider Business Practice Location Address
First Line : 4401 PENN AVENUE
Second Line :
City : PITTSBURGH
State : PA
Zip : 15224-1334
Country : US
Telephone Number : 412-692-5540
Fax Number : 773-834-0748
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2023
Last Update Date : 03/11/2026

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Directions to “ AMANDA RAQUEL SOTO PEREZ ” Practice Location

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