Provider Demographics
NPI:1487797015
Name:ROVIRA SOTO, SONIA I (MD)
Entity type:Individual
Prefix:DR
First Name:SONIA
Middle Name:I
Last Name:ROVIRA 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 2312
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-8312
Mailing Address - Country:US
Mailing Address - Phone:787-646-6098
Mailing Address - Fax:787-265-8278
Practice Address - Street 1:CARR. 404 KM. 0.1
Practice Address - Street 2:#126
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-3037
Practice Address - Fax:787-826-3037
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2017-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12291207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR88963ROOtherTRIPLE S
PR212291OtherMCS
PRG63140Medicare UPIN
PR88963Medicare ID - Type Unspecified