Provider Demographics
NPI:1629018726
Name:SOLORZANO, MARIA CLAUDIA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CLAUDIA
Last Name:SOLORZANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 DRUID CIR STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4307
Mailing Address - Country:US
Mailing Address - Phone:863-676-8935
Mailing Address - Fax:863-679-2691
Practice Address - Street 1:1110 DRUID CIR STE A
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4307
Practice Address - Country:US
Practice Address - Phone:863-676-8935
Practice Address - Fax:863-679-2691
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90317208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU2882YOtherMEDICARE ID INDIVIDUAL
FL294954OtherAVMED
FL270403000Medicaid
FL50341OtherBLUE CROSS/ BLUE SHIELD OF FLORIDA
FLU2882YOtherMEDICARE ID INDIVIDUAL