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General NPI Number Information
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NPI Number | 1164295721
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Entity Type | Organization
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Legal Business Name | SOLVIVE OUTPATIENT SERVICES LLC
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 390 NE 191ST ST STE 8572
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City | MIAMI
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State | FL
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Zip | 33179-3899
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Country | US
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Telephone | 954-902-8274
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Fax | 949-695-4959
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Provider Business Mailing Address
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Address Line | 390 NE 191ST ST STE 8572
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City | MIAMI
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State | FL
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Zip | 33179-3899
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Country | US
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Telephone | 954-902-8274
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Fax | 949-695-4959
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Authorized Official
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Title or Position | AMBR
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Name | MRS. CAROLINA BUITRAGO
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Credential | APRN
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Telephone | 305-904-4495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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