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General NPI Number Information
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NPI Number | 1083128573
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Entity Type | Individual
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Provider Name | CHLOE JEAN SOLIS MD, LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1881 SE TIFFANY AVE STE 102
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7567
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Country | US
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Telephone | 772-398-7936
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Fax | 772-398-7970
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Provider Business Mailing Address
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Address Line | 1881 SE TIFFANY AVE STE 102
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7567
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Country | US
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Telephone | 772-398-7936
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Fax | 772-398-7970
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW14823
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | ME175814
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | TRN36735
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License Number State | FL
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