Healthcare Provider Details

I. General information

NPI: 1235049016
Provider Name (Legal Business Name): SOL COMMUNITY FOUNDATION CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9380 SW 72ND ST STE B240
MIAMI FL
33173-5483
US

IV. Provider business mailing address

9380 SW 72ND ST STE B240
MIAMI FL
33173-5483
US

V. Phone/Fax

Practice location:
  • Phone: 786-534-4979
  • Fax: 786-534-4985
Mailing address:
  • Phone: 786-534-4979
  • Fax: 786-534-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LEIDY EXPOSITO DE LA CRUZ
Title or Position: OWNER
Credential:
Phone: 786-534-4979