Provider Demographics
NPI:1922418904
Name:SORRENTINO, DANTE MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANTE
Middle Name:MICHAEL
Last Name:SORRENTINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 W BAY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3276
Mailing Address - Country:US
Mailing Address - Phone:727-585-2200
Mailing Address - Fax:
Practice Address - Street 1:1030 W BAY DR STE 200
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3276
Practice Address - Country:US
Practice Address - Phone:727-585-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155316207W00000X
NMRS2017-0887390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology