Healthcare Provider Details

I. General information

NPI: 1174401210
Provider Name (Legal Business Name): MONETTE FLORES SOLOMON CRNP, AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W MONTGOMERY AVE
ARDMORE PA
19003-1416
US

IV. Provider business mailing address

185 WILDE AVE
DREXEL HILL PA
19026-3418
US

V. Phone/Fax

Practice location:
  • Phone: 610-649-2433
  • Fax:
Mailing address:
  • Phone: 609-969-9040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP033622
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: