Provider Demographics
NPI:1245850908
Name:SOLARI, JAMES G
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:SOLARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 LOTUS LN N
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4423
Mailing Address - Country:US
Mailing Address - Phone:904-610-9702
Mailing Address - Fax:
Practice Address - Street 1:828 LOTUS LN N
Practice Address - Street 2:
Practice Address - City:ST JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-4423
Practice Address - Country:US
Practice Address - Phone:904-610-9702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-23
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17959101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health