MEDICARE: SOL PEDIATRICS LLC

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
1	261Q00000X	Clinic/Center	ME-100281	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1326455387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOL PEDIATRICS LLC

Provider Business Mailing Address
First Line	:	255 WESTWARD DR
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-5259
Country	:	US
Telephone Number	:	786-621-9777
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 WESTWARD DR
Second Line	:
City	:	MIAMI SPRINGS
State	:	FL
Zip	:	33166-5259
Country	:	US
Telephone Number	:	786-621-9777
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	AGUSTIN RIVAS
Credential	:
Telephone Number	:	256-412-0478

Provider Enumeration Date	:	07/22/2014
Last Update Date	:	01/07/2026

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Directions to “SOL PEDIATRICS LLC ” Practice Location

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