MEDICARE: ROSEMARY SOLOMON

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	164W00000X	Licensed Practical Nurse	644451	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NONE	OTHER		NOT APPLICABLE

General Provider Information

NPI Number	:	1356951933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY SOLOMON

Provider Business Mailing Address
First Line	:	2207 S CONGRESS AVE STE A
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-7600
Country	:	US
Telephone Number	:	561-969-3926
Fax Number	:	561-969-1351

Provider Business Practice Location Address
First Line	:	2207 S CONGRESS AVE STE A
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-7600
Country	:	US
Telephone Number	:	561-969-3926
Fax Number	:	561-969-1351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2020
Last Update Date	:	08/07/2020

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Directions to “ ROSEMARY SOLOMON ” Practice Location

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