Provider Demographics
NPI:1679717862
Name:LOPRESTO, SOLIANID (LMT)
Entity type:Individual
Prefix:MRS
First Name:SOLIANID
Middle Name:
Last Name:LOPRESTO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 BRISTOL BAY WAY
Mailing Address - Street 2:#302
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-3665
Mailing Address - Country:US
Mailing Address - Phone:813-390-1231
Mailing Address - Fax:
Practice Address - Street 1:4809 BRISTOL BAY WAY
Practice Address - Street 2:#302
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-3665
Practice Address - Country:US
Practice Address - Phone:813-390-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA53430174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist