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NPI Code Detail

MEDICARE: JENNIFER SOLOMON OTR/L

MEDICARE:   JENNIFER  SOLOMON  OTR/L
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
1225X00000XOccupational Therapist19247FL

General Provider Information

NPI Number : 1700351467
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER SOLOMON OTR/L
Provider Business Mailing Address
First Line : 13051 GRAN BAY PKWY UNIT 1228
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32258-6512
Country : US
Telephone Number : 203-482-2920
Fax Number :
Provider Business Practice Location Address
First Line : 145 HILDEN RD STE 113
Second Line :
City : PONTE VEDRA BEACH
State : FL
Zip : 32081-8401
Country : US
Telephone Number : 904-652-5408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2018
Last Update Date : 10/09/2018

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Directions to “ JENNIFER SOLOMON OTR/L” Practice Location

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