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Dr. Marisa Lynn Soto

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NPI Number Detailed Information

Provider Information:

Name: Dr. Marisa Lynn Soto
Gender: F
Provider License Number If Given: 6207

NPI Information:

NPI: 1154324150
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: 1326 W HOPBUSH WAY
Tucson, AZ 85704
Phone Number: 5208886854
Fax Number:

Provider Business Practice Location Address:

Address: 7490 S CAMINO DE OESTE
Tucson, AZ 85746
Phone Number: 5208796224
Fax Number: 5208833833

Provider Taxonomy:

Primary: 183500000X
Secondary (if any): 1835P1200X
State: AZ

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