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NPI Code Detail

MEDICARE: THEODOSIOS SOLDATOS MD

MEDICARE: THEODOSIOS SOLDATOS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME68179FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114992625
Entity Type Code : Individual
Provider Name (Legal Business Name) : THEODOSIOS SOLDATOS MD
Provider Business Mailing Address
First Line : 1302 RIVER ST
Second Line :
City : PALATKA
State : FL
Zip : 32177-5042
Country : US
Telephone Number : 386-328-8371
Fax Number : 386-328-1519
Provider Business Practice Location Address
First Line : 100 COMMERCIAL DR
Second Line :
City : KEYSTONE HEIGHTS
State : FL
Zip : 32656-6802
Country : US
Telephone Number : 352-473-6595
Fax Number : 352-473-6597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2006
Last Update Date : 10/29/2013

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Directions to “ THEODOSIOS SOLDATOS MD” Practice Location

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