Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DN 20025 | FL |
NPI | 1619056280 |
---|---|
Provider Name | Dr. Lynn W. Solomon |
First Address | Ft Lauderdale, FL 33329-0370 |
Second Address | Davie, FL 33328-2018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 06/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V11732 | (02) | MA |