Provider Demographics
NPI:1346357506
Name:SOHAIL, ISHRAT (MD)
Entity Type:Individual
Prefix:MRS
First Name:ISHRAT
Middle Name:
Last Name:SOHAIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 N ORANGE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804
Mailing Address - Country:US
Mailing Address - Phone:407-894-7880
Mailing Address - Fax:407-894-7882
Practice Address - Street 1:2702 N ORANGE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804
Practice Address - Country:US
Practice Address - Phone:407-894-7880
Practice Address - Fax:407-894-7882
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME034999208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL065562701OtherMEDIPASS
FL065562700Medicaid
FL065562700Medicaid