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NPI Code Detail

MEDICARE: MADELAINE PIMENTEL DEL SOL

MEDICARE: MADELAINE PIMENTEL DEL SOL
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
1363LF0000XFamily Nurse Practitioner11009863FL
2104100000XSocial Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528566379
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELAINE PIMENTEL DEL SOL
Provider Business Mailing Address
First Line : 12171 SW 268TH ST
Second Line :
City : HOMESTEAD
State : FL
Zip : 33032-8001
Country : US
Telephone Number : 305-278-0200
Fax Number :
Provider Business Practice Location Address
First Line : 11211 N NEBRASKA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-5777
Country : US
Telephone Number : 813-514-2333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2018
Last Update Date : 02/19/2024

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Directions to “ MADELAINE PIMENTEL DEL SOL ” Practice Location

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