Provider Demographics
NPI:1073574331
Name:SOLARUS ENTERPRISES, LLC
Entity Type:Organization
Organization Name:SOLARUS ENTERPRISES, LLC
Other - Org Name:SOLARUS MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:813-994-6688
Mailing Address - Street 1:10347 CROSS CREEK BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2993
Mailing Address - Country:US
Mailing Address - Phone:813-994-6688
Mailing Address - Fax:813-994-6666
Practice Address - Street 1:10347 CROSS CREEK BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2993
Practice Address - Country:US
Practice Address - Phone:813-994-6688
Practice Address - Fax:866-643-9605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312499332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNAOtherFIRST COAST ADVANTAGE
FLNAOtherHEALTHEASE IN SELECT COUNTIES
FL1073574331OtherUNITED HEALTHCARE BENESIGHT HARRINGTION
FLNAOtherSUNSHINE STATE HEALTH PLAN
FLNAOtherAETNA
FLR9670OtherBLUE CROSS BLUE SHIELD FL
FL1073574331OtherPED-I-CARE
FL1073574331OtherEVOLUTIONS HEALTHCARE SYSTEM
FLNAOtherINTEGRAL QUALITY CARE
FL1028538OtherUNITED HEALTHCARE
FL1073574331Medicaid
FLNAOtherHUMANA
FLNAOtherUMR
FL11141501OtherCITRUS HEALTHCARE
FLNAOtherCOVENTRY NATIONAL NETWORK
FL1073574331OtherUNITED HEALTHCARE GOLDEN RULE
1073574331OtherTHREE RIVERS NETWORK
FLNAOtherSTAYWELL IN SELECT COUNTIES
FLNAOtherCIGNA
FLNAOtherASSURANT HEALTH PLAN
FL1073574331Medicaid
FLNAOtherSUNSHINE STATE HEALTH PLAN
FLNAOtherCOVENTRY NATIONAL NETWORK
FLNAOtherSTAYWELL IN SELECT COUNTIES
FL=========OtherMULTIPLAN
FLNAOtherHUMANA