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NPI 1568431419

NPI 1568431419 : MABEL ROSA SOLA MD : MELBOURNE, FL

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General NPI Number Information
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    NPI Number           |    1568431419
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    Entity Type          |    Individual 
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    Provider Name        |    MABEL ROSA SOLA MD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/14/2006
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    Last Update Date     |    07/06/2023
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Provider Practice Location Address
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    Address Line         |    20 E MELBOURNE AVE STE 101 
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    City                 |    MELBOURNE
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    State                |    FL
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    Zip                  |    32901-5970
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    Country              |    US
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    Telephone            |    321-312-1167
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    Fax                  |    321-312-1201
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Provider Business Mailing Address
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    Address Line         |    601 S HARBOUR ISLAND BLVD STE 200 
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    City                 |    TAMPA
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    State                |    FL
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    Zip                  |    33602-5925
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    Country              |    US
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    Telephone            |    800-480-5243
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    Fax                  |    800-928-7449
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208D00000X
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    Taxonomy Name        |    General Practice Physician
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    License Number       |    14932
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    License Number State |    PR
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