Provider Demographics
NPI:1689026924
Name:SOMORIN, ABISOYE (DNP, ARNP)
Entity Type:Individual
Prefix:DR
First Name:ABISOYE
Middle Name:
Last Name:SOMORIN
Suffix:
Gender:M
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 ORANGE AVE STE 238
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4310
Mailing Address - Country:US
Mailing Address - Phone:386-872-8534
Mailing Address - Fax:386-204-7309
Practice Address - Street 1:128 ORANGE AVE STE 238
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4310
Practice Address - Country:US
Practice Address - Phone:386-872-8534
Practice Address - Fax:386-204-7309
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLARNP9355850363LF0000X, 363LP2300X
FLAPRN9355850363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9355850OtherBOARD OF NURSING