Provider Demographics
NPI:1457114837
Name:SOLER, ROBERTO A
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:A
Last Name:SOLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14221 SW 120TH ST STE 228
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4225
Mailing Address - Country:US
Mailing Address - Phone:786-330-9563
Mailing Address - Fax:
Practice Address - Street 1:14221 SW 120TH ST STE 228
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4225
Practice Address - Country:US
Practice Address - Phone:786-330-9563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11030923363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care