Provider Demographics
NPI:1588305858
Name:RODRIGUEZ SOTO, SARYBETH (APRN)
Entity type:Individual
Prefix:
First Name:SARYBETH
Middle Name:
Last Name:RODRIGUEZ SOTO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 ARONIMINIK DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-8725
Mailing Address - Country:US
Mailing Address - Phone:407-994-9586
Mailing Address - Fax:
Practice Address - Street 1:1001 N LK DESTINY RD
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4159
Practice Address - Country:US
Practice Address - Phone:407-303-7125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-02
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11018953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11018953OtherSTATE LICENSE