Provider Demographics
NPI:1881871671
Name:SOLIS, ENGELBERT ARIOSA
Entity type:Individual
Prefix:MR
First Name:ENGELBERT
Middle Name:ARIOSA
Last Name:SOLIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ENGELBERT
Other - Middle Name:ARIOSA
Other - Last Name:SOLIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:11120 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2633
Mailing Address - Country:US
Mailing Address - Phone:301-642-0434
Mailing Address - Fax:
Practice Address - Street 1:11120 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2633
Practice Address - Country:US
Practice Address - Phone:301-592-8200
Practice Address - Fax:301-592-8300
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist