Provider Demographics
NPI:1366475659
Name:ANA J. SOLIS, MD, PA
Entity Type:Organization
Organization Name:ANA J. SOLIS, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-774-1234
Mailing Address - Street 1:9995 SW 72ND ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4662
Mailing Address - Country:US
Mailing Address - Phone:786-289-0759
Mailing Address - Fax:305-280-4129
Practice Address - Street 1:9995 SW 72ND ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4662
Practice Address - Country:US
Practice Address - Phone:786-289-0759
Practice Address - Fax:305-280-4129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL208D00000XOtherTAXONOMY CODE
FL208D00000XOtherTAXONOMY CODE
FL=========OtherTAX ID NUMBER