Provider Demographics
NPI:1356491161
Name:ROSENBLATT, SOLON L (MD)
Entity Type:Individual
Prefix:
First Name:SOLON
Middle Name:L
Last Name:ROSENBLATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 PHAY AVE BLDG D
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-2326
Mailing Address - Country:US
Mailing Address - Phone:719-285-2646
Mailing Address - Fax:
Practice Address - Street 1:1338 PHAY AVE BLDG D
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2326
Practice Address - Country:US
Practice Address - Phone:719-285-2646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65801207X00000X
CODR.0063229207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A658010Medicaid
G80067Medicare UPIN
CA00A658010Medicaid