Active NPI
Dalisla Soto, M.D.
- Family Medicine Physician
- Miami, FL
National Provider Identifier
1164407201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME059438
- Practice address
- 1801 NW 9TH Ave
Suite 206
Miami, FL 33136-1005 - Phone
- (786) 466-8490
- Fax
- (305) 573-6562
- NPI assigned
- Dec 13, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME059438 | FL | Primary |
Addresses
Primary practice location
1801 NW 9TH Ave
Suite 206
Miami, FL 33136-1005
Mailing address
PO Box 12493
JMG Specialty Physicians
Miami, FL 33101-2493
Phone (305) 585-6649
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54444200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME059438 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Public Health Trust of Dade County Florida | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Miami, FL
- NPI 1902978695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483660800000",
"number": "1164407201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12493",
"address_2": "JMG SPECIALTY PHYSICIANS",
"city": "MIAMI",
"state": "FL",
"postal_code": "331012493",
"telephone_number": "305-585-6649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 NW 9TH AVE",
"address_2": "SUITE 206",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361005",
"telephone_number": "786-466-8490",
"fax_number": "305-573-6562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO",
"first_name": "DALISLA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-13",
"last_updated": "2017-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME059438",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54444200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.