MEDICARE: SALOMON FAMILY SERVICES

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	251T00000X	PACE Provider Organization	685650196	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326207101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALOMON FAMILY SERVICES

Provider Business Mailing Address
First Line	:	3184 W 72ND ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-5222
Country	:	US
Telephone Number	:	305-828-2071
Fax Number	:	305-364-9296

Provider Business Practice Location Address
First Line	:	3184 W 72ND ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33018-5222
Country	:	US
Telephone Number	:	305-828-2071
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RAFAEL SALOMON
Credential	:
Telephone Number	:	305-828-2071

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	06/05/2008

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Directions to “SALOMON FAMILY SERVICES ” Practice Location

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