MEDICARE: FREDERICK E SOLIMAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	OS17222	FL

General Provider Information

NPI Number	:	1063705879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERICK E SOLIMAN D.O.

Provider Business Mailing Address
First Line	:	3451 TECHNOLOGICAL AVE STE 15
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-8353
Country	:	US
Telephone Number	:	407-380-8705
Fax Number	:	407-643-2804

Provider Business Practice Location Address
First Line	:	3451 TECHNOLOGICAL AVE STE 15
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32817-8353
Country	:	US
Telephone Number	:	407-380-8705
Fax Number	:	407-643-2804

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2011
Last Update Date	:	04/20/2021

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