Basic Information
| Provider Information | |||||||||
| NPI: | 1518037365 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOLANGEL | ||||||||
| FirstName: | MARIANA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MANZANARES ARCE | ||||||||
| OtherFirstName: | MARIA | ||||||||
| OtherMiddleName: | CLAUDIA | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1007 N FEDERAL HWY # 179 | ||||||||
| Address2: | |||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333041422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4242622672 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4900 W OAKLAND PARK BLVD STE 105 | ||||||||
| Address2: | |||||||||
| City: | LAUDERDALE LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333131555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8446654827 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 10/15/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | MFC1607 | FL | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 208D00000X | ME 103343 | FL | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.