Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | ACN1100 | FL |
NPI | 1023476140 |
---|---|
Provider Name | Enrique Solis Lafont |
First Address | Miami, FL 33170-7602 |
Second Address | Miami Gardens, FL 33169-5371 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2016 |
Last Update Date | 06/02/2019 |