1104433200 NPI number — DR. JUAN PABLO SOLANO ROMERO MD

Table of content: DR. JUAN PABLO SOLANO ROMERO MD (NPI 1104433200)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104433200 NPI number — DR. JUAN PABLO SOLANO ROMERO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOLANO ROMERO
Provider First Name:
JUAN
Provider Middle Name:
PABLO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104433200
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 BOYLSTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTNUT HILL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02467-2477
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-732-9060
Provider Business Mailing Address Fax Number:
617-732-9050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 BOYLSTON ST STE 320
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESTNUT HILL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02467-2402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-732-9060
Provider Business Practice Location Address Fax Number:
617-732-9050
Provider Enumeration Date:
09/23/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com