Individual provider Active NPI

Maria Claudia Solorzano, M.D.

  • Pediatrics Physician
  • Lake Wales, FL
National Provider Identifier
1629018726
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME90317 Issued in FL
Practice address
1110 Druid Cir Ste a
Lake Wales, FL 33853-4307
Phone
(863) 676-8935
Fax
(863) 679-2691
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME90317 FL Primary

Addresses

Primary practice location

1110 Druid Cir Ste a
Lake Wales, FL 33853-4307

Mailing address

1110 Druid Cir Ste a
Lake Wales, FL 33853-4307
Phone (863) 676-8935

Other identifiers 4

IdentifierTypeStateIssuer
U2882YOtherFLMEDICARE ID INDIVIDUAL
294954OtherFLAVMED
270403000MedicaidFL
50341OtherFLBLUE CROSS/ BLUE SHIELD OF FLORIDA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040818001404 FL Practitioner - Pediatric Medicine 6901879774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Wale Pediatric Internal Medicine P.a.Group PAC ID 0446325013, 2 clinicians

Practice addresses (Care Compare)

425 11TH St
Suite 2
Lake Wales, FL 33853-4239

425 S 11TH St
Lake Wales, FL 33853-4239
Phone (863) 676-8935

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Wale Pediatric Internal Medicine P.a. CurrentSince May 7, 2014 Accepting new patients

Locations

1110 Druid Cir
Ste A
Lake Wales, FL 33853
Phone (863) 676-8935

425 S 11th St
Ste 2
Lake Wales, FL 33853
Phone (863) 676-8935

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1629018726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 DRUID CIR STE A",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534307",
            "telephone_number": "863-676-8935",
            "fax_number": "863-679-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 DRUID CIR STE A",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534307",
            "telephone_number": "863-676-8935",
            "fax_number": "863-679-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLORZANO",
        "first_name": "MARIA",
        "middle_name": "CLAUDIA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME90317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID INDIVIDUAL",
            "identifier": "U2882Y",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "294954",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270403000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD OF FLORIDA",
            "identifier": "50341",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.