MEDICARE: DR. INGRID SOLOMON 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	208D00000X	General Practice Physician	OS8956	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OS8956	OTHER	FL	LICENSE

General Provider Information

NPI Number	:	1932247830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. INGRID SOLOMON D.O.

Provider Business Mailing Address
First Line	:	1281 NW 95TH AVE
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33322-4824
Country	:	US
Telephone Number	:	954-530-8608
Fax Number	:

Provider Business Practice Location Address
First Line	:	6931 W BROWARD BLVD
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-2902
Country	:	US
Telephone Number	:	954-321-5191
Fax Number	:	954-321-5191

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	06/05/2015

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