Provider Demographics
NPI:1639327810
Name:SOLANA, JORGE ENRIQUE
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ENRIQUE
Last Name:SOLANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:ENRIQUE
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5390 SW 91ST AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6649
Mailing Address - Country:US
Mailing Address - Phone:305-527-5415
Mailing Address - Fax:
Practice Address - Street 1:429 SW 136TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1054
Practice Address - Country:US
Practice Address - Phone:305-527-5415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 6704235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist