Provider Demographics
NPI:1376068940
Name:SOLTERO, JONNATHAN DAVID (ARNP)
Entity Type:Individual
Prefix:
First Name:JONNATHAN
Middle Name:DAVID
Last Name:SOLTERO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:JONNATHAN
Other - Middle Name:DAVID
Other - Last Name:SOLTERO-VAZQUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:3185 W VINE ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-3738
Mailing Address - Country:US
Mailing Address - Phone:407-569-1260
Mailing Address - Fax:833-963-0109
Practice Address - Street 1:3185 W VINE ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-3738
Practice Address - Country:US
Practice Address - Phone:407-569-1260
Practice Address - Fax:833-963-0109
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9296863363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily