MEDICARE: JLSOLANA JR INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0400X	Rehabilitation Chiropractor	CHIR006734	GA

General Provider Information

NPI Number	:	1285757526
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JLSOLANA JR INC

Provider Business Mailing Address
First Line	:	2851 EDGEWOOD AVE N
Second Line	:	SUITE 18
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-1400
Country	:	US
Telephone Number	:	904-359-5464
Fax Number	:	904-359-5460

Provider Business Practice Location Address
First Line	:	2851 EDGEWOOD AVE N
Second Line	:	SUITE 18
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-1400
Country	:	US
Telephone Number	:	904-359-5464
Fax Number	:	904-359-5460

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES LOUIS SOLANA JR.
Credential	:	D.C.
Telephone Number	:	904-359-5464

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	08/22/2020

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