Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME0092887 | FL |
NPI | 1053323063 |
---|---|
Provider Name | Dr. Joseph Carlyle Soto |
First Address | Tallahassee, FL 32308-4655 |
Second Address | Tallahassee, FL 32308-4655 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
16319 | BCBS (01) | FL |
272303400 | (05) | FL |
396746207A | (05) | GA |
I35564 | (02) | FL |