Provider Demographics
NPI:1326151093
Name:SOFER, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:SOFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BOSTON AVE STE 202
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4712
Mailing Address - Country:US
Mailing Address - Phone:407-906-0077
Mailing Address - Fax:407-571-9085
Practice Address - Street 1:106 BOSTON AVE.,
Practice Address - Street 2:SUITE 202
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-3500
Practice Address - Country:US
Practice Address - Phone:407-906-0077
Practice Address - Fax:407-571-9085
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9213111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor