Provider Demographics
NPI:1710648381
Name:SOLVER, MAILA STA ROMANA (PT)
Entity Type:Individual
Prefix:
First Name:MAILA
Middle Name:STA ROMANA
Last Name:SOLVER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MAILA
Other - Middle Name:PITUK
Other - Last Name:STA ROMANA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3753 GRANDEWOOD BLVD APT 434
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7355
Mailing Address - Country:US
Mailing Address - Phone:224-789-6089
Mailing Address - Fax:
Practice Address - Street 1:3753 GRANDEWOOD BLVD APT 434
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7355
Practice Address - Country:US
Practice Address - Phone:224-789-6089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL37405225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist