MEDICARE: DR. PEDRO MIGUEL SOLER JR. 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
1	208200000X	Plastic Surgery Physician	ME70059	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1134128010	OTHER	FL	NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134128010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO MIGUEL SOLER JR. MD

Provider Business Mailing Address
First Line	:	13015 W LINEBAUGH AVE STE 102
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-4506
Country	:	US
Telephone Number	:	813-878-9889
Fax Number	:	813-872-9560

Provider Business Practice Location Address
First Line	:	4144 N. ARMENIA AVE
Second Line	:	SUITE 250
City	:	TAMPA
State	:	FL
Zip	:	33607
Country	:	US
Telephone Number	:	813-878-9889
Fax Number	:	813-872-9560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	12/09/2021

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