Jack H Soliman MD PA

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

ME0064892 Issued in FL

Legal business name

JACK H SOLIMAN MD PA

Practice address

6100 Saint Johns Ave
Suite 1
Palatka, FL 32177-3844

Phone

(386) 328-1117

Fax

(386) 328-0533

NPI assigned

Dec 13, 2011

Last updated

Dec 13, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jack H Soliman, MD PA

Title

Owner

Phone

(386) 328-1117

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1689942047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SAINT JOHNS AVE",
            "address_2": "SUITE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773844",
            "telephone_number": "386-328-1117",
            "fax_number": "386-328-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 SAINT JOHNS AVE",
            "address_2": "SUITE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773844",
            "telephone_number": "386-328-1117",
            "fax_number": "386-328-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK H SOLIMAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "SOLIMAN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-328-1117",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "FL",
            "license": "ME0064892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Palatka, FL
• Providers in Palatka, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.