Individual
DANA TATE-SOLOMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5449 S SEMORAN BLVD, SUITE 14, ORLANDO, FL 32822-1722
(407) 322-8645
(407) 322-8725
Mailing address
2400 STATE ROAD 415, SUITE 14, SANFORD, FL 32771-6012
(407) 322-8645
(407) 330-5074
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9101341
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01115657
AMERIGROUP
FL
01
—
206129
WELLCARE
FL
05
—
682190100
—
FL
Enumeration date
02/20/2006
Last updated
04/30/2020
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