MEDICARE: GREGORY G SOLIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME67747	FL
2	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	ME67747	FL
3	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	ME67747	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00294581	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659344489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY G SOLIS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 44004
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32231-4004
Country	:	US
Telephone Number	:	904-202-1032
Fax Number	:	904-880-1210

Provider Business Practice Location Address
First Line	:	14534 OLD SAINT AUGUSTINE RD STE 3220
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-2645
Country	:	US
Telephone Number	:	904-880-1260
Fax Number	:	904-880-1210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	03/25/2021

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Directions to “ GREGORY G SOLIS M.D.” Practice Location

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