MEDICARE: MR. ALFRED 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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	SW19121	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

General Provider Information

NPI Number	:	1467788711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALFRED SOLOMON

Provider Business Mailing Address
First Line	:	PO BOX 82969
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33682-2969
Country	:	US
Telephone Number	:	813-866-0930
Fax Number	:	813-405-3722

Provider Business Practice Location Address
First Line	:	4620 N 22ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-6205
Country	:	US
Telephone Number	:	813-397-5300
Fax Number	:	813-247-5591

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

Provider Enumeration Date	:	10/21/2009
Last Update Date	:	12/16/2022

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Directions to “ MR. ALFRED SOLOMON ” Practice Location

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