Provider Demographics
NPI:1467265025
Name:SOTO, LUIS M (PHARMACIST)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:M
Last Name:SOTO
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CALLE PALMA DE MARIPOSA
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5801
Mailing Address - Country:US
Mailing Address - Phone:939-464-7810
Mailing Address - Fax:
Practice Address - Street 1:9 CALLE PALMA DE MARIPOSA
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5801
Practice Address - Country:US
Practice Address - Phone:939-464-7810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist