Provider Demographics
NPI:1023001765
Name:SOLER SALAS, ANTONIO H (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:H
Last Name:SOLER SALAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 163 1353 CARR 19
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2700
Mailing Address - Country:US
Mailing Address - Phone:787-798-7070
Mailing Address - Fax:787-787-2107
Practice Address - Street 1:CARIMED PLZ
Practice Address - Street 2:B-1 CALLE SANTA CRUZ SUITE 403-404
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6928
Practice Address - Country:US
Practice Address - Phone:787-798-7070
Practice Address - Fax:787-787-2107
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-29
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9185207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR81181OtherTRIPLE S
PR6220098OtherHUMANA
PR81181Medicare ID - Type Unspecified
PR81181OtherTRIPLE S