Provider Demographics
NPI:1538327945
Name:SOLOMON, JULIE ANNE (PA-C)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNE
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-444-4471
Mailing Address - Fax:401-444-7574
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-4471
Practice Address - Fax:401-444-7574
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL2077172V00000X
FLPA9107485208M00000X, 363A00000X
RIPA01703363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No172V00000XOther Service ProvidersCommunity Health Worker
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL2077OtherATHLETIC TRAINER LICENSURE
FL010370200Medicaid