Eduardo Soliman Plantilla, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040.0003678 Issued in VT

Practice address

321 Main St Ste D
Winooski, VT 05404-1380

Phone

(802) 864-3785

Fax

(802) 864-0274

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1457471237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MAIN ST STE D",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041380",
            "telephone_number": "802-864-3785",
            "fax_number": "802-864-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MAIN ST STE D",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041380",
            "telephone_number": "802-864-3785",
            "fax_number": "802-864-0274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Kimball Ave",
            "address_2": "Suite 115",
            "address_purpose": "LOCATION",
            "city": "South Burlington",
            "state": "VT",
            "postal_code": "054036833",
            "country_code": "US",
            "telephone_number": "802-658-5756",
            "fax_number": "802-865-0042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Brook Dr",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054081103",
            "country_code": "US",
            "telephone_number": "802-598-9259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLANTILLA",
        "first_name": "EDUARDO",
        "middle_name": "SOLIMAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0003678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Winooski, VT
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.