Provider Demographics
NPI:1942249073
Name:SORIANO, ALBERT IBAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:IBAN
Last Name:SORIANO
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 1:2025 GLENN MITCHELL DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-0178
Mailing Address - Country:US
Mailing Address - Phone:757-507-4123
Mailing Address - Fax:
Practice Address - Street 1:2025 GLENN MITCHELL DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0178
Practice Address - Country:US
Practice Address - Phone:757-507-4123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101224316207R00000X, 208M00000X
FLME75833207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254949200Medicaid
FL110195640OtherRAILROAD MEDICARE
G78962Medicare UPIN
FL254949200Medicaid