Provider Demographics
NPI:1245378587
Name:SOVI JOSEPH MD PA
Entity Type:Organization
Organization Name:SOVI JOSEPH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:SOVI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-258-9500
Mailing Address - Street 1:3440 TAMIAMI TRL
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-8134
Mailing Address - Country:US
Mailing Address - Phone:941-258-9500
Mailing Address - Fax:941-258-9501
Practice Address - Street 1:3440 TAMIAMI TRL
Practice Address - Street 2:SUITE 1
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8134
Practice Address - Country:US
Practice Address - Phone:941-258-9500
Practice Address - Fax:941-258-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77185207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49257OtherBCBS OF FL
FL49257OtherBCBS OF FL
FLAD111Medicare PIN