Healthcare Provider Details

I. General information

NPI: 1518107713
Provider Name (Legal Business Name): DR. INGRID SOLOMON INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2009
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 NE 163RD ST APT 3J
NORTH MIAMI BEACH FL
33160-4430
US

IV. Provider business mailing address

2821 NE 163RD ST APT 3J
NORTH MIAMI BEACH FL
33160-4430
US

V. Phone/Fax

Practice location:
  • Phone: 305-949-2158
  • Fax:
Mailing address:
  • Phone: 305-949-2158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberOS8956
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberOS8956
License Number StateFL

VIII. Authorized Official

Name: DR. INGRID PATRICIA SOLOMON
Title or Position: DIRECTOR
Credential: D.O.
Phone: 305-949-2158