Organization
POINCIANA MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN A RIVERA SOLER MD (MD)
(407) 572-8862
Entity
Organization
Contact information
Practice address
51 N DOVERPLUM AVE, KISSIMMEE, FL 34758-3308
(407) 572-8862
(407) 572-8863
Mailing address
51 N DOVERPLUM AVE, KISSIMMEE, FL 34758-3308
(407) 572-8862
(407) 572-8863
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ACN241
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001456400
—
FL
Enumeration date
11/25/2013
Last updated
07/21/2014
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