Provider Demographics
NPI:1801174628
Name:BELANDRES, SOLITA M (RPT)
Entity type:Individual
Prefix:
First Name:SOLITA
Middle Name:M
Last Name:BELANDRES
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7922 SHADOW LAKE DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-4602
Mailing Address - Country:US
Mailing Address - Phone:402-319-6691
Mailing Address - Fax:402-932-1888
Practice Address - Street 1:3110 SCOTT CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-2604
Practice Address - Country:US
Practice Address - Phone:402-203-6112
Practice Address - Fax:402-932-1888
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE1229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist