Provider Demographics
NPI:1366650228
Name:ERNESTO R SOLTERO MD PSC
Entity Type:Organization
Organization Name:ERNESTO R SOLTERO MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:R
Authorized Official - Last Name:OLIVERAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-848-1010
Mailing Address - Street 1:PO BOX 801202
Mailing Address - Street 2:COTO LAUREL
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1202
Mailing Address - Country:US
Mailing Address - Phone:787-848-1010
Mailing Address - Fax:787-259-7364
Practice Address - Street 1:CARDIOVASCUALR SURGERY CENTER HOSPITAL DAMAS
Practice Address - Street 2:2213 PONCE BY PASS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-848-1010
Practice Address - Fax:787-259-7364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12695174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0089264Medicare ID - Type Unspecified