Provider Demographics
NPI:1043820558
Name:CALIXTRO, SOLINA
Entity Type:Individual
Prefix:
First Name:SOLINA
Middle Name:
Last Name:CALIXTRO
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 1:10252 S US HWY 441
Mailing Address - Street 2:UNITS 3&4
Mailing Address - City:BELLVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10252 SE US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-6819
Practice Address - Country:US
Practice Address - Phone:352-559-2539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician