Provider Demographics
NPI:1114944949
Name:ALEX SOLLER MD PA
Entity Type:Organization
Organization Name:ALEX SOLLER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-392-4106
Mailing Address - Street 1:801 MEADOWS RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2346
Mailing Address - Country:US
Mailing Address - Phone:561-392-4105
Mailing Address - Fax:561-391-9355
Practice Address - Street 1:801 MEADOWS RD
Practice Address - Street 2:SUITE 118
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2346
Practice Address - Country:US
Practice Address - Phone:561-392-4105
Practice Address - Fax:561-391-9355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1209Medicare ID - Type Unspecified