Individual
CAULLEY FONVIELLE SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1720 S GADSDEN ST, TALLAHASSEE, FL 32301-5506
(850) 576-4073
(850) 576-2824
Mailing address
1720 S GADSDEN ST, TALLAHASSEE, FL 32301-5506
(850) 576-4073
(850) 576-2824
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME96885
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281225800
—
FL
01
—
SG097141
VISTA
FL
Enumeration date
04/10/2008
Last updated
10/15/2010
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