Provider Demographics
NPI:1306899760
Name:SOTO RAICES, OHEL (MD)
Entity type:Individual
Prefix:DR
First Name:OHEL
Middle Name:
Last Name:SOTO RAICES
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 1:67 CALLE COBANA
Mailing Address - Street 2:LADERAS DE SAN JUAN
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9322
Mailing Address - Country:US
Mailing Address - Phone:787-764-3566
Mailing Address - Fax:787-751-2212
Practice Address - Street 1:MONTE MALL
Practice Address - Street 2:SUITE 3215
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-764-3566
Practice Address - Fax:787-751-2212
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR153812084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry