Active NPI
Solace Medical Care PB LLC
- Family Medicine Physician
- Palm Bay, FL
National Provider Identifier
1114605706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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 DirectoryLocations
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.