Provider Demographics
NPI:1881990802
Name:SOMA MEDICAL CENTER, PA 2
Entity type:Organization
Organization Name:SOMA MEDICAL CENTER, PA 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALOMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-360-2034
Mailing Address - Street 1:3145 S CONGRESS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2553
Mailing Address - Country:US
Mailing Address - Phone:561-360-2034
Mailing Address - Fax:561-360-2650
Practice Address - Street 1:3145 S CONGRESS AVE STE B
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2553
Practice Address - Country:US
Practice Address - Phone:561-360-2034
Practice Address - Fax:561-360-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-09
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101616208000000X
FLPA9104829363AM0700X
FLME76971261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255695200Medicaid
FL44868AMedicare UPIN