Provider Demographics
NPI:1306320858
Name:TRIANA, SOLEDAD (PA-C)
Entity type:Individual
Prefix:
First Name:SOLEDAD
Middle Name:
Last Name:TRIANA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LN
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7176
Mailing Address - Country:US
Mailing Address - Phone:800-400-3376
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:615 WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33972-7954
Practice Address - Country:US
Practice Address - Phone:866-400-3376
Practice Address - Fax:239-561-3020
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9111573363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant