Provider Demographics
NPI:1801027339
Name:SOLIVAN, ARICELIS (RPT)
Entity Type:Individual
Prefix:
First Name:ARICELIS
Middle Name:
Last Name:SOLIVAN
Suffix:
Gender:F
Credentials:RPT
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 468
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-0468
Mailing Address - Country:US
Mailing Address - Phone:787-270-2686
Mailing Address - Fax:
Practice Address - Street 1:ISIS STREET J-8
Practice Address - Street 2:VILLAS DE BUENA VISTA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-5952
Practice Address - Country:US
Practice Address - Phone:787-692-3560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR951225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist