Provider Demographics
NPI:1518945666
Name:SOUTO, ENRICO OLIVEIRA (MD)
Entity type:Individual
Prefix:
First Name:ENRICO
Middle Name:OLIVEIRA
Last Name:SOUTO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5101 SW 8ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-359-5037
Mailing Address - Fax:786-509-5544
Practice Address - Street 1:9195 SW 72 ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173
Practice Address - Country:US
Practice Address - Phone:305-243-8644
Practice Address - Fax:305-243-9927
Is Sole Proprietor?:No
Enumeration Date:2006-01-07
Last Update Date:2023-11-22
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Provider Licenses
StateLicense IDTaxonomies
FLME111338207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2120399Medicaid
MAJ40389OtherBLUE CROSS
MEG93410Medicare UPIN
MA2120399Medicaid