Healthcare Provider Details

I. General information

NPI: 1831136001
Provider Name (Legal Business Name): PEDRO M SOLER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4144 N ARMENIA AVE STE 250
TAMPA FL
33607-6447
US

IV. Provider business mailing address

4144 N ARMENIA AVE STE 250
TAMPA FL
33607-6447
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 Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberME70059
License Number StateFL

VIII. Authorized Official

Name: PEDRO M SOLER
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 813-878-9889