Provider Demographics
NPI:1376759472
Name:SOLIS, KATYHIUSKA
Entity Type:Individual
Prefix:
First Name:KATYHIUSKA
Middle Name:
Last Name:SOLIS
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:I 11CALLE 6
Mailing Address - Street 2:PARQUE SAN MIGUEL
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-4218
Mailing Address - Country:US
Mailing Address - Phone:787-251-3798
Mailing Address - Fax:
Practice Address - Street 1:I11 CALLE 6
Practice Address - Street 2:PARQUE SAN MIGUEL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-4218
Practice Address - Country:US
Practice Address - Phone:787-251-3798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist