Provider Demographics
NPI:1861522674
Name:SOLTERO-VENEGAS, EDMEE M (MD)
Entity type:Individual
Prefix:DR
First Name:EDMEE
Middle Name:M
Last Name:SOLTERO-VENEGAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 367901
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7901
Mailing Address - Country:US
Mailing Address - Phone:787-282-3261
Mailing Address - Fax:787-767-1288
Practice Address - Street 1:400 AVE DOMENECH
Practice Address - Street 2:SUITE 402 LAS AMERICAS PROFF. CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3710
Practice Address - Country:US
Practice Address - Phone:787-282-3261
Practice Address - Fax:787-767-1288
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9922208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR82195Medicare PIN
PR8-2195Medicare ID - Type Unspecified