Basic Information
| Provider Information | |||||||||
| NPI: | 1821445560 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEL SOL | ||||||||
| FirstName: | ANGELICA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10900 SW 196TH ST | ||||||||
| Address2: | APT 122 N | ||||||||
| City: | CUTLER BAY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331578347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7863157432 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2468 SW 137TH AVE | ||||||||
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| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331756330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7868326630 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2016 | ||||||||
| LastUpdateDate: | 07/19/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 106S00000X | Y |
No ID Information.