Basic Information
| Provider Information | |||||||||
| NPI: | 1851720700 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOLIS | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | FELIPE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99 EAST RIVER DR 5TH FLOOR | ||||||||
| Address2: | MEDICAL ANESTHESIOLOGY ASSOCIATES PC | ||||||||
| City: | EAST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061087301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602824133 | ||||||||
| FaxNumber: | 8602890746 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 TRAP FALLS RD | ||||||||
| Address2: | SUITE 414 | ||||||||
| City: | SHELTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064847623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2039297353 | ||||||||
| FaxNumber: | 2039290756 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2013 | ||||||||
| LastUpdateDate: | 09/05/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 081976 | CT | N | Nursing Service Providers | Licensed Practical Nurse | 367500000X | 5632 | CT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.