Provider Demographics
NPI:1386093474
Name:ZAMORA, SOLISA
Entity type:Individual
Prefix:MS
First Name:SOLISA
Middle Name:
Last Name:ZAMORA
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 1:444 DRAKE CT APT D
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-6530
Mailing Address - Country:US
Mailing Address - Phone:505-901-9245
Mailing Address - Fax:
Practice Address - Street 1:444 DRAKE CT APT D
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-6530
Practice Address - Country:US
Practice Address - Phone:505-901-9245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other