Provider Demographics
NPI:1376595736
Name:LAM, SOFIA (MD)
Entity type:Individual
Prefix:DR
First Name:SOFIA
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16051 COLLINS AVE APT 803
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4509
Mailing Address - Country:US
Mailing Address - Phone:215-620-8582
Mailing Address - Fax:215-885-8861
Practice Address - Street 1:16051 COLLINS AVE APT 803
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4509
Practice Address - Country:US
Practice Address - Phone:215-620-8582
Practice Address - Fax:215-885-8861
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93193207LP2900X
PAMD036352E207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA594859Medicare PIN
PAE52964Medicare UPIN