Provider Demographics
NPI:1124064092
Name:SOTO, LUIS F (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:F
Last Name:SOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 HOUMA BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006
Mailing Address - Country:US
Mailing Address - Phone:504-455-3500
Mailing Address - Fax:504-455-3006
Practice Address - Street 1:4300 HOUMA BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006
Practice Address - Country:US
Practice Address - Phone:504-455-3500
Practice Address - Fax:504-455-3006
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06730R207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1367443Medicaid
LA1367443Medicaid
LA53086Medicare PIN