Healthcare Provider Details

I. General information

NPI: 1326036294
Provider Name (Legal Business Name): SOL A ROBLES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. SOL A ROBLES-GONZALEZ

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LUQUILLO PLAZA LOCAL 14
LUQUILLO PR
00773
US

IV. Provider business mailing address

PO BOX 1442 CALLE 14 #173 PARCELA PORTUNA
LUQUILLO PR
00773-1442
US

V. Phone/Fax

Practice location:
  • Phone: 787-206-2122
  • Fax:
Mailing address:
  • Phone: 787-206-2122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number14686
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: