Healthcare Provider Details
I. General information
NPI: 1083225692
Provider Name (Legal Business Name): DIANA MARIA SOLER CPM, LND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/17/2020
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1857 AVE PONCE DE LEON
SAN JUAN PR
00909-1907
US
IV. Provider business mailing address
520 CALLE LOGRONO
CAGUAS PR
00727-1424
US
V. Phone/Fax
- Phone: 787-300-1498
- Fax:
- Phone: 787-300-1498
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 176B00000X |
| Taxonomy | Midwife |
| License Number | 12080034 |
| License Number State | PR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133NN1002X |
| Taxonomy | Nutrition Education Nutritionist |
| License Number | 1391 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: