Provider Demographics
NPI:1073265229
Name:SOLANO, ADISNEY
Entity Type:Individual
Prefix:
First Name:ADISNEY
Middle Name:
Last Name:SOLANO
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 1:10020 SW 224TH ST APT 105
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1145
Mailing Address - Country:US
Mailing Address - Phone:305-484-7604
Mailing Address - Fax:
Practice Address - Street 1:10020 SW 224TH ST APT 105
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1145
Practice Address - Country:US
Practice Address - Phone:305-484-7604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator