Soto Executive Enterprise, LLC

Primary specialty

Forensic Psychiatry PhysicianTaxonomy code 2084F0202X

Legal business name

SOTO EXECUTIVE ENTERPRISE, LLC

Practice address

5227 Spring Branch Blvd
Montclair, VA 22025-3048

Phone

(571) 288-3440

NPI assigned

Jan 5, 2021

Last updated

Jan 5, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Rafael Soto III

Title

President & Ceo

Phone

(571) 288-3440

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1093303182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5227 SPRING BRANCH BLVD",
            "city": "MONTCLAIR",
            "state": "VA",
            "postal_code": "220253048",
            "telephone_number": "571-288-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5227 SPRING BRANCH BLVD",
            "city": "MONTCLAIR",
            "state": "VA",
            "postal_code": "220253048",
            "telephone_number": "571-288-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOTO EXECUTIVE ENTERPRISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "SOTO",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "571-288-3440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.