Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9229185 | FL |
NPI | 1003049990 |
---|---|
Provider Name | Adelene Soto |
First Address | Clermont, FL 34711-8907 |
Second Address | Lakeland, FL 33809-4308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2009 |
Last Update Date | 17/11/2009 |