Provider Demographics
NPI:1912174145
Name:SOTO, ELDER O (RPH)
Entity type:Individual
Prefix:
First Name:ELDER
Middle Name:O
Last Name:SOTO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8337 SOUTH PARK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819
Mailing Address - Country:US
Mailing Address - Phone:407-345-7415
Mailing Address - Fax:407-345-7420
Practice Address - Street 1:8337 SOUTH PARK CIRCLE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-541-4864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST021997183500000X
OKR17255183500000X
MST12787183500000X
GARPH026805183500000X
ORRPH0013558183500000X
WVRP0009489183500000X
AL18422183500000X
TN35682183500000X
PR04483183500000X
FLPS37543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist