MEDICARE: SANTIAGO MIGUEL DE SOLO 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
1	207RR0500X	Rheumatology Physician	ME0059911	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	:	1871568618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANTIAGO MIGUEL DE SOLO MD

Provider Business Mailing Address
First Line	:	7190 SW 87TH AVE
Second Line	:	304
City	:	MIAMI
State	:	FL
Zip	:	33173-2512
Country	:	US
Telephone Number	:	305-661-2299
Fax Number	:	305-666-0458

Provider Business Practice Location Address
First Line	:	7190 SW 87TH AVE
Second Line	:	304
City	:	MIAMI
State	:	FL
Zip	:	33173-2512
Country	:	US
Telephone Number	:	305-661-2299
Fax Number	:	305-666-0458

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	10/06/2021

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