Provider Demographics
NPI:1851325138
Name:SOVIS, MICHAEL ROBERT (NP)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ROBERT
Last Name:SOVIS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2055 MILITARY TRL
Mailing Address - Street 2:SUITE 303
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7801
Mailing Address - Country:US
Mailing Address - Phone:561-427-0860
Mailing Address - Fax:561-427-0870
Practice Address - Street 1:2055 MILITARY TRL
Practice Address - Street 2:SUITE 303
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7801
Practice Address - Country:US
Practice Address - Phone:561-427-0860
Practice Address - Fax:561-427-0870
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP2803282207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD78841Medicare UPIN