Basic Information
| Provider Information | |||||||||
| NPI: | 1801841978 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOTO | ||||||||
| FirstName: | ELIANA | ||||||||
| MiddleName: | AMPARO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 LOYOLA AVE | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701139521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045589595 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1057 PAUL MAILLARD ROAD | ||||||||
| Address2: | |||||||||
| City: | LULING | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9857852218 | ||||||||
| FaxNumber: | 9857857753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 10/15/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 201700 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1035122 | 05 | LA | MEDICAID | 201700 | 01 | LA | STATE MEDICAL BOARD | OTHER |