Provider Demographics
NPI:1093771099
Name:SORIANO, ALEJANDRO L (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:L
Last Name:SORIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-1652
Mailing Address - Country:US
Mailing Address - Phone:270-821-1229
Mailing Address - Fax:270-821-1220
Practice Address - Street 1:550 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1652
Practice Address - Country:US
Practice Address - Phone:270-821-1229
Practice Address - Fax:270-821-1220
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY273922080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64273923Medicaid
KY64273923Medicaid
KY1835601Medicare ID - Type Unspecified