Provider Demographics
NPI:1255377305
Name:NIFFENEGGER, ARYSOL SOLTERO (MD)
Entity type:Individual
Prefix:
First Name:ARYSOL
Middle Name:SOLTERO
Last Name:NIFFENEGGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 BEE RIDGE RD
Mailing Address - Street 2:BLDG D
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1207
Mailing Address - Country:US
Mailing Address - Phone:941-924-0303
Mailing Address - Fax:
Practice Address - Street 1:3920 BEE RIDGE RD
Practice Address - Street 2:BLDG D
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1207
Practice Address - Country:US
Practice Address - Phone:941-924-0303
Practice Address - Fax:941-924-0309
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88191207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268109900Medicaid
FL71622ZMedicare PIN
FLF64512Medicare UPIN