Provider Demographics
NPI:1346326899
Name:SONI, MAHESH M (MD)
Entity type:Individual
Prefix:MR
First Name:MAHESH
Middle Name:M
Last Name:SONI
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 1:2194 N HWY A1A
Mailing Address - Street 2:
Mailing Address - City:INDIA HARBOR BCH
Mailing Address - State:FL
Mailing Address - Zip Code:32937
Mailing Address - Country:US
Mailing Address - Phone:321-777-6869
Mailing Address - Fax:321-777-1029
Practice Address - Street 1:2194 N HWY A1A #201
Practice Address - Street 2:
Practice Address - City:INDIA HARBOR BCH
Practice Address - State:FL
Practice Address - Zip Code:32937
Practice Address - Country:US
Practice Address - Phone:321-777-6869
Practice Address - Fax:321-777-1029
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46046208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL201720Medicaid
FL593360315OtherCOMMERCIAL INSURANCE
FL044145702Medicaid
FL216816Medicaid
FL27939Medicaid
FL05567OtherBLUECROSS BLUESHIELD
FL4038938OtherAETNA
FL40462OtherBLUECROSS BLUESHIELD