1437624368 NPI number — MRS. LOURDES MABEL SOTO REGISTRED NURSE

Table of content: MRS. LOURDES MABEL SOTO REGISTRED NURSE (NPI 1437624368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437624368 NPI number — MRS. LOURDES MABEL SOTO REGISTRED NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOTO
Provider First Name:
LOURDES
Provider Middle Name:
MABEL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
REGISTRED NURSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SOTO TRAVERSO
Provider Other First Name:
LOURDES
Provider Other Middle Name:
M.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RNBSN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437624368
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
367 CALLE FORTALEZA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00901-1715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-244-0780
Provider Business Mailing Address Fax Number:
787-723-6247

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 C CERRA FINAL PARADA 15
Provider Second Line Business Practice Location Address:
CDT DR GUALBERTO RABELL
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-480-3789
Provider Business Practice Location Address Fax Number:
787-723-6247
Provider Enumeration Date:
10/08/2018

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: 163W00000X , with the licence number:  18541 , 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)





Copyright © 2007-2025 www.npivalidator.com