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Individual

MR. OMAR SOTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
CARR. # 2 KM 117.6, SECTOR CEIBA BAJA, AGUADILLA, PR 00603
(787) 891-2173
Mailing address
HC 8 BOX 45293, AGUADILLA, PR 00603-9772
(787) 891-2173
(787) 891-2173

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
TCAMB339
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0057169
PROVIDER MEDICARE
PR
01
50620
PMC
PR
01
890518
MMM
PR
Enumeration date
10/07/2008
Last updated
10/07/2008
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