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General NPI Number Information
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NPI Number | 1104481753
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Entity Type | Individual
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Provider Name | FELIPE SOLANO DE LA SALA
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Gender | Male
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 05/08/2019
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Provider Practice Location Address
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Address Line | 202 W OLD COUNTRY RD
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City | HICKSVILLE
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State | NY
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Zip | 11801-4011
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Country | US
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Telephone | 516-688-6057
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Fax | 215-465-1008
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Provider Business Mailing Address
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Address Line | 11605 N LAMAR BLVD
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City | AUSTIN
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State | TX
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Zip | 78753-2658
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Country | US
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Telephone | 737-222-6996
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Fax |
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 008017
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License Number State | NY
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