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General NPI Number Information
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NPI Number | 1316638273
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Entity Type | Organization
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Legal Business Name | LA CLINICA DEL SOL PLLC
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Dates
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Enumeration Date | 05/19/2023
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 1880 OFFICE CLUB PT STE 235
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-5017
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Country | US
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Telephone | 719-200-2243
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Fax | 833-216-0396
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Provider Business Mailing Address
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Address Line | 1880 OFFICE CLUB PT STE 235
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-5017
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Country | US
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Telephone | 719-200-2243
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Fax | 833-216-0396
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Authorized Official
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Title or Position | OWNER
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Name | CECILIO CARDENAS
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Credential | NP
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Telephone | 719-200-2243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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