Provider Demographics
NPI:1801205992
Name:SOLER-CUMMINGS, ELAYNE
Entity Type:Individual
Prefix:
First Name:ELAYNE
Middle Name:
Last Name:SOLER-CUMMINGS
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 1:2880 DAVID WALKER DR # 135
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-6172
Mailing Address - Country:US
Mailing Address - Phone:407-906-7455
Mailing Address - Fax:
Practice Address - Street 1:2880 DAVID WALKER DR #135
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6172
Practice Address - Country:US
Practice Address - Phone:407-906-7455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLISW9942OtherFLORIDA DEPARTMENT OF HEALTH REGISTERED CLINICAL SOCIAL WORKER INTERN
FLSW14824OtherFLORIDA DEPARTMENT OF HEALTH LICENSED CLINICAL SOCIAL WORKER