MEDICARE: SANDRA SOLOMON

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	235Z00000X	Speech-Language Pathologist	SA3583	FL

General Provider Information

NPI Number	:	1770945636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA SOLOMON

Provider Business Mailing Address
First Line	:	600 THREE ISLANDS BLVD
Second Line	:	AJPT 219
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2888
Country	:	US
Telephone Number	:	954-907-3580
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 THREE ISLANDS BLVD
Second Line	:	APT 219
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2888
Country	:	US
Telephone Number	:	954-907-3580
Fax Number	:

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

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/22/2016

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Directions to “ SANDRA SOLOMON ” Practice Location

Language	Start Address	Practice Location

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