Provider Demographics
NPI:1811342207
Name:SOLANO, SANDRALIZ (MD)
Entity type:Individual
Prefix:
First Name:SANDRALIZ
Middle Name:
Last Name:SOLANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANDRALIZ
Other - Middle Name:
Other - Last Name:HERNANDEZ BANCHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3842 HELMSMAN DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-0719
Mailing Address - Country:US
Mailing Address - Phone:239-473-3600
Mailing Address - Fax:
Practice Address - Street 1:7935 AIRPORT PULLING RD
Practice Address - Street 2:SUITE 210
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120
Practice Address - Country:US
Practice Address - Phone:239-369-9779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8856093390200000X
FLME140733207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103594800Medicaid