Healthcare Provider Details

I. General information

NPI: 1134128010
Provider Name (Legal Business Name): PEDRO MIGUEL SOLER JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4144 N. ARMENIA AVE SUITE 250
TAMPA FL
33607
US

IV. Provider business mailing address

13015 W LINEBAUGH AVE STE 102
TAMPA FL
33626-4506
US

V. Phone/Fax

Practice location:
  • Phone: 813-878-9889
  • Fax: 813-872-9560
Mailing address:
  • Phone: 813-878-9889
  • Fax: 813-872-9560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME70059
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: