Provider Demographics
NPI:1730605809
Name:SOTO PEREZ, YIGALYS
Entity type:Individual
Prefix:
First Name:YIGALYS
Middle Name:
Last Name:SOTO PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 NW 198TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-1829
Mailing Address - Country:US
Mailing Address - Phone:954-709-6744
Mailing Address - Fax:
Practice Address - Street 1:4275 NW 198TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-1829
Practice Address - Country:US
Practice Address - Phone:954-709-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician