Provider Demographics
NPI:1386034205
Name:SOTERIA MEDICAL, LLC
Entity Type:Organization
Organization Name:SOTERIA MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ENTOLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PROVIDER ENROLLMENT
Authorized Official - Phone:818-340-0265
Mailing Address - Street 1:9150 SW 87TH AVENUE
Mailing Address - Street 2:213
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2313
Mailing Address - Country:US
Mailing Address - Phone:305-595-4447
Mailing Address - Fax:
Practice Address - Street 1:9150 SW 87TH AVENUE
Practice Address - Street 2:213
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2313
Practice Address - Country:US
Practice Address - Phone:305-595-4447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty