Organization
SOLARIS WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GISELLE IBANEZ (CEO)
(954) 306-3889
Entity
Organization
Contact information
Practice address
2320 NE 9TH ST # 200, FORT LAUDERDALE, FL 33304-3579
(305) 586-2088
Mailing address
2320 NE 9TH ST # 200, FORT LAUDERDALE, FL 33304-3579
(954) 306-3889
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
251B00000X
Case Management Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
04/07/2019
Last updated
06/30/2020
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