1104522887 NPI number — LUIGGI PEREZ SOTO PHARMD

Table of content: LUIGGI PEREZ SOTO PHARMD (NPI 1104522887)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104522887 NPI number — LUIGGI PEREZ SOTO PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEREZ SOTO
Provider First Name:
LUIGGI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
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:
1104522887
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3005
Provider Second Line Business Mailing Address:
HATO ARRIBA STATION
Provider Business Mailing Address City Name:
SAN SEBASTIAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00685
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-877-3432
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRETERA 111 KM 14.5
Provider Second Line Business Practice Location Address:
BARRIO HATO ARRIBA
Provider Business Practice Location Address City Name:
SAN SEBASTIAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00685
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-896-6340
Provider Business Practice Location Address Fax Number:
787-896-3036
Provider Enumeration Date:
02/03/2023

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: 183500000X , with the licence number:  008052 , 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)

  • Identifier: 008052 . This is a "PUERTO RICO PHARMACY BOARD" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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