1477924090 NPI number — MR. DAMASO SOTO ORTEGA SR. MCSW 13080

Table of content: MR. DAMASO SOTO ORTEGA SR. MCSW 13080 (NPI 1477924090)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477924090 NPI number — MR. DAMASO SOTO ORTEGA SR. MCSW 13080

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORTEGA
Provider First Name:
DAMASO SOTO
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
MCSW 13080
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:
1477924090
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
A11 HACIENDA OLIVIERY
Provider Second Line Business Mailing Address:
URB SANTA MARIA
Provider Business Mailing Address City Name:
GUAYANILLA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-375-7077
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
A 11 HACIENDA OLIVIERY
Provider Second Line Business Practice Location Address:
URB SANTA MARIA
Provider Business Practice Location Address City Name:
GUAYANILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-375-7077
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/08/2015

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: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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