MEDICARE: DR. SAMUEL RAMIREZ SOTO M.D.

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	208D00000X	General Practice Physician	12102	PR

General Provider Information

NPI Number	:	1942203401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL RAMIREZ SOTO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1537
Second Line	:
City	:	AGUADA
State	:	PR
Zip	:	00602-1537
Country	:	US
Telephone Number	:	787-868-5158
Fax Number	:

Provider Business Practice Location Address
First Line	:	53B CALLE VICTORIA
Second Line	:
City	:	ANASCO
State	:	PR
Zip	:	00610-2609
Country	:	US
Telephone Number	:	787-826-6695
Fax Number	:

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	04/25/2019

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