Provider Demographics
NPI:1639163207
Name:SOLER, JOSE R (MD, FACC)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:R
Last Name:SOLER
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-884-0111
Mailing Address - Fax:954-366-6120
Practice Address - Street 1:2901 CORAL HILLS DR STE 240250
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4146
Practice Address - Country:US
Practice Address - Phone:954-884-0111
Practice Address - Fax:954-366-6120
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0063935207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006389200Medicaid
D07217Medicare UPIN
D07217Medicare UPIN