Provider Demographics
NPI:1205885613
Name:SOFI, ABDUL HAMID (MD)
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:HAMID
Last Name:SOFI
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:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32348-0719
Mailing Address - Country:US
Mailing Address - Phone:850-584-3278
Mailing Address - Fax:850-584-8171
Practice Address - Street 1:315 E ASH ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32347-2029
Practice Address - Country:US
Practice Address - Phone:850-584-3278
Practice Address - Fax:850-584-8171
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95758207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275575100Medicaid
FL275575100Medicaid