Provider Demographics
NPI:1487376364
Name:SOLOMON, DALVIN JAMES
Entity type:Individual
Prefix:
First Name:DALVIN
Middle Name:JAMES
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7672 NW 5TH ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1982
Mailing Address - Country:US
Mailing Address - Phone:954-993-2067
Mailing Address - Fax:
Practice Address - Street 1:560 VILLAGE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1963
Practice Address - Country:US
Practice Address - Phone:561-806-4850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician