Healthcare Provider Details

I. General information

NPI: 1598425233
Provider Name (Legal Business Name): SOLARIA URGENT AND PRIMARY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5481 SW 60TH ST UNIT 301
OCALA FL
34474-5653
US

IV. Provider business mailing address

5481 SW 60TH ST UNIT 301
OCALA FL
34474-5653
US

V. Phone/Fax

Practice location:
  • Phone: 352-504-0092
  • Fax: 352-504-0165
Mailing address:
  • Phone: 352-504-0092
  • Fax: 352-504-0162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VANESSA BLANCO
Title or Position: MANAGING MEMBER
Credential: APRN-FNP-C
Phone: 352-504-0092