Provider Demographics
NPI:1194318758
Name:SOLANO-DAVIS, LESBIA E
Entity type:Individual
Prefix:
First Name:LESBIA
Middle Name:E
Last Name:SOLANO-DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15400 SW 284TH ST UNIT 1106
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-1311
Mailing Address - Country:US
Mailing Address - Phone:786-683-2786
Mailing Address - Fax:
Practice Address - Street 1:15400 SW 284TH ST UNIT 1106
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1311
Practice Address - Country:US
Practice Address - Phone:786-683-2786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-118252106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician