Provider Demographics
NPI:1700590478
Name:SOFFE, TAMMY RYAM (APRN)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:RYAM
Last Name:SOFFE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SW 8TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0952
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 SW 8TH ST
Practice Address - Street 2:STE B
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0952
Practice Address - Country:US
Practice Address - Phone:352-369-0104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022897207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine