Basic Information
| Provider Information | |||||||||
| NPI: | 1508972373 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOTO RODRIGUEZ | ||||||||
| FirstName: | ZY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6307 SWANSON ST | ||||||||
| Address2: | |||||||||
| City: | WINDERMERE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347864118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7873764194 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 17410 HWY 50 | ||||||||
| Address2: | STE 110 | ||||||||
| City: | CLERMONT | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347118188 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072402361 | ||||||||
| FaxNumber: | 4073458895 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2006 | ||||||||
| LastUpdateDate: | 02/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 16501 | PR | N | Allopathic & Osteopathic Physicians | General Practice | 208D00000X | ACN585 | FL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.