Provider Demographics
NPI:1649097510
Name:SOLOMON, GABRIELA N/A
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:N/A
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 N 17TH CT APT 10
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-2855
Mailing Address - Country:US
Mailing Address - Phone:954-226-3149
Mailing Address - Fax:
Practice Address - Street 1:1825 N 17TH CT APT 10
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-2855
Practice Address - Country:US
Practice Address - Phone:954-226-3149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL09240487363LF0000X
FL11035699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily