MEDICARE: AZURE MEDICAL GROUP LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1245188135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AZURE MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	1955 W GRANT RD STE 125G
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-1470
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1955 W GRANT RD STE 125G
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-1470
Country	:	US
Telephone Number	:	520-668-4978
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	DANIEL SOLOMON
Credential	:	FNP
Telephone Number	:	520-668-4978

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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