Provider Demographics
NPI:1285677328
Name:SOSA, JOHN PAUL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN PAUL
Middle Name:JOSEPH
Last Name:SOSA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3703 ACADIA GLEN LN
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-7918
Mailing Address - Country:US
Mailing Address - Phone:248-613-0489
Mailing Address - Fax:813-454-0059
Practice Address - Street 1:3601 MADACA LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2048
Practice Address - Country:US
Practice Address - Phone:813-314-7943
Practice Address - Fax:813-454-0059
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2020-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME105758207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00699963OtherRAILROAD MEDICARE
FL0016853-00Medicaid
FL0016853-00Medicaid