Provider Demographics
NPI:1639269004
Name:MARIA N. SOLITO MD LLC
Entity Type:Organization
Organization Name:MARIA N. SOLITO MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:NINNA
Authorized Official - Last Name:SOLITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-566-3422
Mailing Address - Street 1:12425 OLD MERIDIAN ST
Mailing Address - Street 2:SUITE B2
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-8724
Mailing Address - Country:US
Mailing Address - Phone:317-566-3422
Mailing Address - Fax:317-566-9111
Practice Address - Street 1:12425 OLD MERIDIAN ST
Practice Address - Street 2:SUITE B2
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8724
Practice Address - Country:US
Practice Address - Phone:317-566-3422
Practice Address - Fax:317-566-9111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051472302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200265880AMedicaid
INH24566Medicare UPIN
IN200265880AMedicaid