Provider Demographics
NPI:1295414803
Name:SOLEIL MEDICAL AND SURGERY LLC
Entity type:Organization
Organization Name:SOLEIL MEDICAL AND SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAXIMILIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-415-7576
Mailing Address - Street 1:18310 MATT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33917-4350
Mailing Address - Country:US
Mailing Address - Phone:239-699-0733
Mailing Address - Fax:
Practice Address - Street 1:11571 VERANDAH BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-6241
Practice Address - Country:US
Practice Address - Phone:239-699-0733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty