Healthcare Provider Details

I. General information

NPI: 1528976982
Provider Name (Legal Business Name): JAQUELINE SOLANO SLPA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13300 SW 120TH ST
MIAMI FL
33186-6429
US

IV. Provider business mailing address

10850 SW 88TH ST APT 115
MIAMI FL
33176-1305
US

V. Phone/Fax

Practice location:
  • Phone: 305-253-8775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number4749
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: