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General NPI Number Information
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NPI Number | 1730352162
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Entity Type | Individual
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Provider Name | SOLANO FERNANDEZ MERCADO PT
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Gender | Male
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 04/07/2008
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Provider Practice Location Address
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Address Line | 2301 TAMIAMI TRL SUITE E
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-3923
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Country | US
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Telephone | 941-625-1252
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Fax | 941-625-0616
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Provider Business Mailing Address
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Address Line | 2301 TAMIAMI TRL STE E
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-3923
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Country | US
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Telephone | 941-625-1252
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Fax | 941-625-0616
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 10237
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | PT 10237
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2251H1300X
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Taxonomy Name | Human Factors Physical Therapist
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License Number | PT 10237
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | PT 10237
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License Number State | FL
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