Individual
REGINA SOLOMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
963 S LAKE SHORE WAY, LAKE ALFRED, FL 33850-3321
(863) 242-3691
Mailing address
4782 OSPREY WAY, WINTER HAVEN, FL 33881-9104
(863) 242-3691
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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