Provider Demographics
NPI:1942770912
Name:SOMA MEDICAL CENTER, P. A #4
Entity Type:Organization
Organization Name:SOMA MEDICAL CENTER, P. A #4
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANCE PRACTICE ADM
Authorized Official - Prefix:
Authorized Official - First Name:PAOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALOMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-275-1155
Mailing Address - Street 1:10125 W COLONIAL DR STE 204
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4200
Mailing Address - Country:US
Mailing Address - Phone:561-275-1155
Mailing Address - Fax:561-275-7151
Practice Address - Street 1:10125 W COLONIAL DR STE 204
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4200
Practice Address - Country:US
Practice Address - Phone:561-281-4707
Practice Address - Fax:561-275-7151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty