Provider Demographics
NPI:1427268770
Name:MARIN SOTO, MARIA DE LOURDES (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DE LOURDES
Last Name:MARIN SOTO
Suffix:
Gender:F
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:PO BOX 1756
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-1756
Mailing Address - Country:US
Mailing Address - Phone:787-761-4200
Mailing Address - Fax:
Practice Address - Street 1:108 CALLE LOAIZA CORDERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3325
Practice Address - Country:US
Practice Address - Phone:787-767-2874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8731207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology