Healthcare Provider Details

I. General information

NPI: 1508507740
Provider Name (Legal Business Name): CRISTIAN SOLANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2022
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 FL-54
TRINITY FL
34655
US

IV. Provider business mailing address

2447 ARBOR WIND DR
LUTZ FL
33558-2603
US

V. Phone/Fax

Practice location:
  • Phone: 727-834-4000
  • Fax:
Mailing address:
  • Phone: 623-330-3623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number110736
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: