Graduated: 1991
NPI: 1053379347
Practice Locations (2)
SOLANTIC OF JACKSONVILLE LLC
2401 MONUMENT RD
JACKSONVILLE, FL 322252520
9046420337
SOLANTIC OF JACKSONVILLE LLC
2140 KINGSLEY AVE
ORANGE PARK, FL 320735180
6156004074
Source: CMS National Downloadable File, September 2026.