Provider Demographics
NPI:1396744272
Name:SONE, MANUEL J (DPM PA)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:J
Last Name:SONE
Suffix:
Gender:M
Credentials:DPM PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9831 NW 58TH ST
Mailing Address - Street 2:SUITE # 127
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2713
Mailing Address - Country:US
Mailing Address - Phone:305-221-6862
Mailing Address - Fax:305-221-2033
Practice Address - Street 1:777 E 25TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3825
Practice Address - Country:US
Practice Address - Phone:305-696-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2282213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390055000Medicaid
FL390055000Medicaid
FLU40412Medicare UPIN
FL65264Medicare ID - Type Unspecified
FL65264BMedicare ID - Type Unspecified