Provider Demographics
NPI:1588870539
Name:SOTO, AMANDA RAQUEL (PHARMD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:RAQUEL
Last Name:SOTO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE CAOBA J6
Mailing Address - Street 2:QUINTAS DE DORADO
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4720
Mailing Address - Country:US
Mailing Address - Phone:787-619-8546
Mailing Address - Fax:
Practice Address - Street 1:J6 CALLE CAOBA
Practice Address - Street 2:QUINTAS DE DORADO
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4720
Practice Address - Country:US
Practice Address - Phone:787-619-8546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1373225100000X
PR69773336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist