Healthcare Provider Details

I. General information

NPI: 1841748217
Provider Name (Legal Business Name): SOL DENTAL PA.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14750 SW 26TH ST SUITE # 210
MIAMI FL
33185-5933
US

IV. Provider business mailing address

14750 SW 26TH ST SUITE # 210
MIAMI FL
33185-5933
US

V. Phone/Fax

Practice location:
  • Phone: 305-400-8060
  • Fax:
Mailing address:
  • Phone: 305-400-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN 18940
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN-13470
License Number StateFL

VIII. Authorized Official

Name: RAMON ANTONIO RODRIGUEZ
Title or Position: GENERAL DENTIST/ OWNER
Credential: DMD
Phone: 305-400-8060