Provider Demographics
NPI:1235968926
Name:SOLER VILLANUEVA, SHEILA ANNETTE
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:ANNETTE
Last Name:SOLER VILLANUEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7265 ACKERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-8083
Mailing Address - Country:US
Mailing Address - Phone:321-469-8060
Mailing Address - Fax:
Practice Address - Street 1:7265 ACKERMAN AVE
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927-8083
Practice Address - Country:US
Practice Address - Phone:321-469-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA22146235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist