Provider Demographics
NPI:1134235088
Name:QUIRINDONGO-SOLANO, FERNANDO LUIS (DPM)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:LUIS
Last Name:QUIRINDONGO-SOLANO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7243 CHASE RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1301
Mailing Address - Country:US
Mailing Address - Phone:313-582-6222
Mailing Address - Fax:313-582-0166
Practice Address - Street 1:508 MEETING ST
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-7535
Practice Address - Country:US
Practice Address - Phone:727-796-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002226213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1134235088Medicaid
MIV09910Medicare UPIN
MI1134235088Medicaid