MEDICARE: EVELYN SOLOMON LMSW

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	1041C0700X	Clinical Social Worker	SW20209	FL
2	1041C0700X	Clinical Social Worker	093856	NY

General Provider Information

NPI Number	:	1508414590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN SOLOMON LMSW

Provider Business Mailing Address
First Line	:	6365 COLLINS AVE APT 2501
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-9617
Country	:	US
Telephone Number	:	802-734-5285
Fax Number	:

Provider Business Practice Location Address
First Line	:	6365 COLLINS AVE APT 2501
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-9617
Country	:	US
Telephone Number	:	802-734-5285
Fax Number	:

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

Provider Enumeration Date	:	09/03/2019
Last Update Date	:	11/10/2023

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Directions to “ EVELYN SOLOMON LMSW” Practice Location

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