Provider Demographics
NPI:1851736292
Name:SOLOMON & SOLOMON MEDICAL CLINIC
Entity Type:Organization
Organization Name:SOLOMON & SOLOMON MEDICAL CLINIC
Other - Org Name:VALERIE T SOLOMON MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-583-1971
Mailing Address - Street 1:1600 N STATE ROAD 7
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5853
Mailing Address - Country:US
Mailing Address - Phone:954-583-1971
Mailing Address - Fax:
Practice Address - Street 1:1600 N STATE ROAD 7
Practice Address - Street 2:SUITE 200
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-5853
Practice Address - Country:US
Practice Address - Phone:954-583-1971
Practice Address - Fax:954-583-1179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0071882173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251818000Medicaid
FL32769AMedicare UPIN