Provider Demographics
NPI:1760888135
Name:SOLIS, EMILIA
Entity Type:Individual
Prefix:
First Name:EMILIA
Middle Name:
Last Name:SOLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 CALLE SAN CARLOS
Mailing Address - Street 2:URB ALTAMESA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-394-7124
Mailing Address - Fax:
Practice Address - Street 1:1423 CALLE SAN CARLOS
Practice Address - Street 2:URB ALTAMESA 1423
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-394-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9367183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician