Individual
ANTONIO SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1155 N MAYFAIR RD, WAUWATOSA, WI 53226-3462
(414) 955-5990
Mailing address
1155 N. MAYFAIR RD., WAUWATOSA, WI 53226
(414) 955-5990
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11761-33
WI
363LP2300X
Primary Care Nurse Practitioner
Primary
11761-33
WI
Other
Enumeration date
02/21/2022
Last updated
02/21/2022
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