Provider Demographics
NPI:1538337332
Name:SOLARES, EMILIO ANTONIO (PT)
Entity type:Individual
Prefix:MR
First Name:EMILIO
Middle Name:ANTONIO
Last Name:SOLARES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19300 W DIXIE HWY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2201
Mailing Address - Country:US
Mailing Address - Phone:305-454-9440
Mailing Address - Fax:305-731-2345
Practice Address - Street 1:19300 W DIXIE HWY
Practice Address - Street 2:SUITE 5
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-2201
Practice Address - Country:US
Practice Address - Phone:305-454-9440
Practice Address - Fax:305-731-2345
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22622225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist