Provider Demographics
NPI:1093203531
Name:SORIANO PHYSICIAN SERVICES PLLC
Entity Type:Organization
Organization Name:SORIANO PHYSICIAN SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YORDANKA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-877-0007
Mailing Address - Street 1:1264 US HIGHWAY 1 STE 105
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2746
Mailing Address - Country:US
Mailing Address - Phone:321-877-0007
Mailing Address - Fax:321-338-2001
Practice Address - Street 1:1264 US HIGHWAY 1 STE 105
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2746
Practice Address - Country:US
Practice Address - Phone:321-877-0007
Practice Address - Fax:321-338-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty