Provider Demographics
NPI:1659344489
Name:SOLIS, GREGORY G (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:G
Last Name:SOLIS
Suffix:
Gender:M
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:PO BOX 44004
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4004
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-880-1210
Practice Address - Street 1:14534 OLD SAINT AUGUSTINE RD STE 3220
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2645
Practice Address - Country:US
Practice Address - Phone:904-880-1260
Practice Address - Fax:904-880-1210
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67747207X00000X, 207XS0114X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00294581OtherRAILROAD MEDICARE
FL2588765-00Medicaid
FL35434WMedicare PIN
FLP00294581OtherRAILROAD MEDICARE
FL35434VMedicare PIN
FL35434XMedicare PIN
FL35434YMedicare PIN