Healthcare Provider Details

I. General information

NPI: 1609822592
Provider Name (Legal Business Name): SOLANTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8711 PERIMETER PARK BLVD SUITE 6
JACKSONVILLE FL
32216-6388
US

IV. Provider business mailing address

8711 PERIMETER PARK BLVD SUITE 6
JACKSONVILLE FL
32216-6388
US

V. Phone/Fax

Practice location:
  • Phone: 904-223-2320
  • Fax:
Mailing address:
  • Phone: 904-223-2330
  • Fax: 904-223-3149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. KAREN BOWLING
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 904-223-2320