Healthcare Provider Details

I. General information

NPI: 1982996278
Provider Name (Legal Business Name): HEATHER SOLORIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2011
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

U.S. NAVAL HOSPITAL GUAM PSC 455
FPO AP
96540-1600
US

IV. Provider business mailing address

4156 BELVEDERE DR
CHESAPEAKE VA
23321-5447
US

V. Phone/Fax

Practice location:
  • Phone: 671-344-9543
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101252499
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: