Provider Demographics
NPI:1033375522
Name:DIAZ-SOLA, MILDRED AILEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MILDRED
Middle Name:AILEEN
Last Name:DIAZ-SOLA
Suffix:
Gender:F
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:PO BOX 51431
Mailing Address - Street 2:LEVITTOWN STATION
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1431
Mailing Address - Country:US
Mailing Address - Phone:787-784-1779
Mailing Address - Fax:
Practice Address - Street 1:CE 11 CALLE DR. FRANCISCO TRELLES
Practice Address - Street 2:LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3312
Practice Address - Country:US
Practice Address - Phone:787-784-1779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR017193208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice