| Doctor Name: | WILMER I SOTO |
| NPI Number: | 1013192574 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA |
| License Number: | 301 |
| Business Practice Address: | Dt28 Calle Lago Icaco 5talevittown Toa Baja, PR - 009493529 |
| Business Phone Number: | 7876332704 |
| Business Fax Number: | |
| Mailing Address: | Dt28 Calle Lago Icaco, 5talevittown TOA BAJA |
| State: | PR |
| Postal Code: | 009493529 |
| Phone Number: | 7876332704 |
| Fax Number: | |
| NPI Enumeration Date: | 01/03/2008 |
| NPI Last Update Date: | 01/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 301 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |