Organization Active NPI

Solaris Wellness Center LLC

  • Psychiatry Physician
  • Fort Lauderdale, FL
National Provider Identifier
1295298354
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SOLARIS WELLNESS CENTER LLC
Practice address
2320 NE 9TH St # 200
Fort Lauderdale, FL 33304-3579
Phone
(305) 586-2088
NPI assigned
Apr 7, 2019
Last updated
Jun 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Giselle Ibanez
Title
Ceo
Phone
(954) 306-3889

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary
Case Management Agency 251B00000X NU
Community Health Clinic/Center 261QC1500X NU

Addresses

Primary practice location

2320 NE 9TH St # 200
Fort Lauderdale, FL 33304-3579

Mailing address

2320 NE 9TH St # 200
Fort Lauderdale, FL 33304-3579
Phone (954) 306-3889

National Provider Directory

National Provider Directory

Locations

2320 NE 9th St
Ste 200
Ft Lauderdale, FL 33304
Phone (305) 586-2088

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1295298354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 NE 9TH ST # 200",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043579",
            "telephone_number": "954-306-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 NE 9TH ST # 200",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333043579",
            "telephone_number": "305-586-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLARIS WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-07",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "IBANEZ",
        "authorized_official_first_name": "GISELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-306-3889"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.