Basic Information
| Provider Information | |||||||||
| NPI: | 1184615056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOTO | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12780 WATERFORD LAKES PKWY STE 120 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328284501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073841053 | ||||||||
| FaxNumber: | 4072778168 | ||||||||
| Practice Location | |||||||||
| Address1: | 12780 WATERFORD LAKES PKWY STE 120 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328284501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073841053 | ||||||||
| FaxNumber: | 4072778168 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2005 | ||||||||
| LastUpdateDate: | 07/31/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME90816 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.