Provider Demographics
NPI:1386845139
Name:SOLIS, DAVID (LICENSED OPTICIAN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SOLIS
Suffix:
Gender:M
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-6557
Mailing Address - Country:US
Mailing Address - Phone:407-880-0335
Mailing Address - Fax:407-880-6782
Practice Address - Street 1:721 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-6557
Practice Address - Country:US
Practice Address - Phone:407-880-0335
Practice Address - Fax:407-880-6782
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO5176156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician