Active NPI
Aida Iris Soto, OT
- Speech-Language Pathologist
- Maitland, FL
National Provider Identifier
1720124514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- OT3260
- Practice address
- 630 N. Maitland Ave
Maitland, FL 32751 - Phone
- (407) 539-2488
- Fax
- (407) 539-2408
- NPI assigned
- Jan 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OT3260 | FL | |
| Speech-Language Pathologist | 235Z00000X | OT3260 | FL | Primary |
Addresses
Primary practice location
630 N. Maitland Ave
Maitland, FL 32751
Mailing address
630 N. Maitland Ave
Maitland, FL 32751
Phone (407) 539-2488
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891150900 | 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299110400000",
"number": "1720124514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 N. MAITLAND AVE",
"city": "MAITLAND",
"state": "FL",
"postal_code": "32751",
"telephone_number": "407-539-2488",
"fax_number": "407-539-2408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 N. MAITLAND AVE",
"city": "MAITLAND",
"state": "FL",
"postal_code": "32751",
"telephone_number": "407-539-2488",
"fax_number": "407-539-2408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO",
"first_name": "AIDA",
"middle_name": "IRIS",
"name_prefix": "Miss",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2011-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OT3260",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "OT3260",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891150900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.