Provider Demographics
NPI:1477215119
Name:SOLIMAN, MOTAZ
Entity Type:Individual
Prefix:
First Name:MOTAZ
Middle Name:
Last Name:SOLIMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1168 MADISON CHASE APT 8
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-3295
Mailing Address - Country:US
Mailing Address - Phone:561-846-9320
Mailing Address - Fax:
Practice Address - Street 1:1168 MADISON CHASE APT 8
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-3295
Practice Address - Country:US
Practice Address - Phone:561-846-9320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA30195208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPTA30195OtherPTA LICENSE