Healthcare Provider Details

I. General information

NPI: 1225977234
Provider Name (Legal Business Name): TRACY LASHAWN SOLOMON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 73
WIMAUMA FL
33598-0073
US

IV. Provider business mailing address

4982 COSMOS CIR APT 406
WIMAUMA FL
33598-4838
US

V. Phone/Fax

Practice location:
  • Phone: 813-862-8161
  • Fax:
Mailing address:
  • Phone: 813-607-5990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: