Provider Demographics
NPI:1336180918
Name:EFRAIN SOTO PEREZ
Entity type:Organization
Organization Name:EFRAIN SOTO PEREZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EFRAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTO PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-882-0157
Mailing Address - Street 1:HC 4 BOX 48313
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9798
Mailing Address - Country:US
Mailing Address - Phone:787-882-0157
Mailing Address - Fax:787-882-0157
Practice Address - Street 1:CARR. 463 KM. 0.1
Practice Address - Street 2:SECTOR LA PALMA
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-882-0157
Practice Address - Fax:787-882-0157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB1713416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR50024OtherPMC
PR820941OtherMMM
PR0059350Medicare ID - Type UnspecifiedPROVIDER