1881660017 NPI number — EDGARDO SOTO QUINONES M,D.

Table of content: EDGARDO SOTO QUINONES M,D. (NPI 1881660017)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881660017 NPI number — EDGARDO SOTO QUINONES M,D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOTO QUINONES
Provider First Name:
EDGARDO
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M,D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881660017
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2904
Provider Second Line Business Mailing Address:
AVE.WASHINGTON F-5 PARKVILLE
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00970-2904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-790-7817
Provider Business Mailing Address Fax Number:
787-708-1181

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AVE.R. RODRIGUEZ B-12
Provider Second Line Business Practice Location Address:
VILLA CLEMENTINA
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969-0969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-708-1181
Provider Business Practice Location Address Fax Number:
787-708-1181
Provider Enumeration Date:
02/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  9104 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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