Provider Demographics
NPI:1790652105
Name:ESTRADA, SOLANH
Entity type:Individual
Prefix:
First Name:SOLANH
Middle Name:
Last Name:ESTRADA
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 1:5410 W 4TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2534
Mailing Address - Country:US
Mailing Address - Phone:786-669-1451
Mailing Address - Fax:
Practice Address - Street 1:5410 W 4TH CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2534
Practice Address - Country:US
Practice Address - Phone:786-669-1451
Practice Address - Fax:786-669-1451
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-21
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician