Provider Demographics
NPI:1275538829
Name:CELINE R. SOLTANI, DPM, P.A
Entity Type:Organization
Organization Name:CELINE R. SOLTANI, DPM, P.A
Other - Org Name:FOOT DOCTOR OF DELRAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CELINE
Authorized Official - Middle Name:REZA
Authorized Official - Last Name:SOLTANI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-498-3893
Mailing Address - Street 1:14428 S MILITARY TRL UNIT B
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-3720
Mailing Address - Country:US
Mailing Address - Phone:561-498-3893
Mailing Address - Fax:
Practice Address - Street 1:14428 S MILITARY TRL UNIT B
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-3720
Practice Address - Country:US
Practice Address - Phone:561-498-3893
Practice Address - Fax:800-551-3458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-19
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3063213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340538900Medicaid
FL65855OtherBCBS #
FL340538900Medicaid
FLU97338Medicare UPIN
FL5390810001Medicare NSC