Provider Demographics
NPI:1497212500
Name:SULTAN SOL, LLC
Entity Type:Organization
Organization Name:SULTAN SOL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:SALGADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-947-3494
Mailing Address - Street 1:1675 MICANOPY AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2542
Mailing Address - Country:US
Mailing Address - Phone:267-694-1282
Mailing Address - Fax:
Practice Address - Street 1:1675 MICANOPY AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2542
Practice Address - Country:US
Practice Address - Phone:267-694-1282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty