Provider Demographics
NPI:1134128010
Name:SOLER, PEDRO MIGUEL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:MIGUEL
Last Name:SOLER
Suffix:JR
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 1:13015 W LINEBAUGH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-4506
Mailing Address - Country:US
Mailing Address - Phone:813-878-9889
Mailing Address - Fax:813-872-9560
Practice Address - Street 1:4144 N. ARMENIA AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-878-9889
Practice Address - Fax:813-872-9560
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70059208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1134128010OtherNPI
FL257171400Medicaid
H19083Medicare UPIN