Healthcare Provider Details

I. General information

NPI: 1770167462
Provider Name (Legal Business Name): MD HEALTH RX SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2021
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3150 PARADISE RD
LAS VEGAS NV
89109-9096
US

IV. Provider business mailing address

14105 MCCORMICK DR
TAMPA FL
33626-3019
US

V. Phone/Fax

Practice location:
  • Phone: 727-601-4513
  • Fax:
Mailing address:
  • Phone: 727-601-4513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KRYSTAL SOLIE
Title or Position: APRN, FNP-BC
Credential:
Phone: 727-601-4513