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NPI Code Detail

MEDICARE: FLORDELYS SOLEDAD MD

MEDICARE: FLORDELYS SOLEDAD MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician4301402294MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225144025
Entity Type Code : Individual
Provider Name (Legal Business Name) : FLORDELYS SOLEDAD MD
Provider Business Mailing Address
First Line : 418 W KALAMAZOO AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49007-3334
Country : US
Telephone Number : 269-553-7037
Fax Number : 269-553-7106
Provider Business Practice Location Address
First Line : 418 W KALAMAZOO AVE
Second Line :
City : KALAMAZOO
State : MI
Zip : 49007-3334
Country : US
Telephone Number : 269-553-7037
Fax Number : 269-553-7106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 07/08/2007

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Directions to “ FLORDELYS SOLEDAD MD” Practice Location

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