Provider Demographics
NPI:1851387377
Name:SOLOMON, DENNIS ROBINS (DO)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ROBINS
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 LAKE POLO DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-1700
Mailing Address - Country:US
Mailing Address - Phone:954-235-7086
Mailing Address - Fax:
Practice Address - Street 1:1330 LAKE POLO DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-1700
Practice Address - Country:US
Practice Address - Phone:954-235-7086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6125207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL37908OtherMEDICARE CORE
FL269904400Medicaid
FL37908XMedicare PIN
FL269904400Medicaid
FL37908DMedicare PIN
FL37908ZMedicare PIN
FL37908YMedicare PIN