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General NPI Number Information
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NPI Number | 1598425233
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Entity Type | Organization
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Legal Business Name | SOLARIA URGENT AND PRIMARY CARE, LLC
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Dates
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Enumeration Date | 12/21/2021
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 5481 SW 60TH ST UNIT 301
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City | OCALA
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State | FL
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Zip | 34474-5653
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Country | US
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Telephone | 352-504-0092
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Fax | 352-504-0165
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Provider Business Mailing Address
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Address Line | 5481 SW 60TH ST UNIT 301
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City | OCALA
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State | FL
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Zip | 34474-5653
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Country | US
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Telephone | 352-504-0092
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Fax | 352-504-0162
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | VANESSA BLANCO
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Credential | APRN-FNP-C
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Telephone | 352-504-0092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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