Provider Demographics
NPI:1699567529
Name:SOTO MEDINA, MARIA VICTORIA (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:VICTORIA
Last Name:SOTO MEDINA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 CALLE CRUZ DE MALTA
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-2709
Mailing Address - Country:US
Mailing Address - Phone:787-430-2620
Mailing Address - Fax:
Practice Address - Street 1:AVE. CARLOS J. ANDALUE IL17
Practice Address - Street 2:ROYAL PALM
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:939-425-6194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1282225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist