Provider Demographics
NPI:1255662128
Name:SOLANILLA, ANGELA MARCELA
Entity type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:MARCELA
Last Name:SOLANILLA
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 1:6750 BOUGANVILLEA CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-6620
Mailing Address - Country:US
Mailing Address - Phone:407-340-7298
Mailing Address - Fax:407-850-2357
Practice Address - Street 1:14048 BRAMBLE BUSH CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-5722
Practice Address - Country:US
Practice Address - Phone:407-383-7082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ4972235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist