Provider Demographics
NPI:1023660800
Name:SOLID SOLUTION HOME CARE
Entity type:Organization
Organization Name:SOLID SOLUTION HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHEVAS
Authorized Official - Middle Name:LESHARN
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-731-4299
Mailing Address - Street 1:2612 SILKWOOD CIR APT 722
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-3378
Mailing Address - Country:US
Mailing Address - Phone:407-731-4299
Mailing Address - Fax:407-951-6552
Practice Address - Street 1:2612 SILKWOOD CIR APT 722
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-3378
Practice Address - Country:US
Practice Address - Phone:407-731-4299
Practice Address - Fax:407-951-6552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100772200Medicaid