Healthcare Provider Details

I. General information

NPI: 1952985616
Provider Name (Legal Business Name): SOLVERA HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 N UNIVERSITY ST
PEORIA IL
61604-1324
US

IV. Provider business mailing address

3525 N UNIVERSITY ST
PEORIA IL
61604-1324
US

V. Phone/Fax

Practice location:
  • Phone: 855-476-5837
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: PATRICK CAPLIS
Title or Position: COO
Credential:
Phone: 855-476-5837