Provider Demographics
NPI:1427870989
Name:SOTO, KARLA MICHELL (PA)
Entity type:Individual
Prefix:DR
First Name:KARLA
Middle Name:MICHELL
Last Name:SOTO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:DR
Other - First Name:KARLA
Other - Middle Name:MICHELLE
Other - Last Name:SOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICIAN ASSITANTS
Mailing Address - Street 1:PO BOX 1772
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-4772
Mailing Address - Country:US
Mailing Address - Phone:787-392-9057
Mailing Address - Fax:
Practice Address - Street 1:6 CALLE LA CRUZ
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-2430
Practice Address - Country:US
Practice Address - Phone:787-837-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2344363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty