Provider Demographics
NPI:1275635294
Name:SOBEL & SOFMAN MD PA
Entity Type:Organization
Organization Name:SOBEL & SOFMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SOFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-983-5830
Mailing Address - Street 1:4340 SHERIDAN STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021
Mailing Address - Country:US
Mailing Address - Phone:954-983-5533
Mailing Address - Fax:954-983-6694
Practice Address - Street 1:4340 SHERIDAN STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:954-983-5533
Practice Address - Fax:954-983-6694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77980Medicare ID - Type Unspecified