Organization Active NPI

Solace Medical Care PB LLC

  • Family Medicine Physician
  • Palm Bay, FL
National Provider Identifier
1114605706
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOLACE MEDICAL CARE PB LLC
Practice address
1890 Palm Bay Rd NE Ste 1
Palm Bay, FL 32905-3071
Phone
(407) 593-2290
NPI assigned
Jul 5, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jos Quezada
Title
Cfo
Phone
(407) 301-8116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1890 Palm Bay Rd NE Ste 1
Palm Bay, FL 32905-3071

Mailing address

10524 Moss Park Rd Ste 204-750
Orlando, FL 32832-5898

National Provider Directory

National Provider Directory

Locations

1890 Palm Bay Rd NE
Ste 1
Palm Bay, FL 32905
Phone (321) 327-3009

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1114605706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10524 MOSS PARK RD STE 204-750",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328325898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 PALM BAY RD NE STE 1",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053071",
            "telephone_number": "407-593-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLACE MEDICAL CARE PB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "QUEZADA",
        "authorized_official_first_name": "JOS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "407-301-8116"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.