Provider Demographics
NPI:1932272010
Name:CALAGUA SOLIS, LITA ROSA (MD)
Entity Type:Individual
Prefix:DR
First Name:LITA
Middle Name:ROSA
Last Name:CALAGUA SOLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10650 W SR 84
Mailing Address - Street 2:SUITE 211
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1807
Mailing Address - Country:US
Mailing Address - Phone:954-476-8126
Mailing Address - Fax:954-449-8940
Practice Address - Street 1:10650 W SR 84
Practice Address - Street 2:SUITE 211
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33324-1807
Practice Address - Country:US
Practice Address - Phone:954-476-8126
Practice Address - Fax:954-301-4655
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME781502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263966100Medicaid
FL263966100Medicaid
FLE3949BMedicare PIN