Provider Demographics
NPI:1932858123
Name:SOMILEA GROUP LLC
Entity Type:Organization
Organization Name:SOMILEA GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:SOSA CHIRINOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-323-5039
Mailing Address - Street 1:101 SAGE OAK LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-4017
Mailing Address - Country:US
Mailing Address - Phone:404-323-5039
Mailing Address - Fax:
Practice Address - Street 1:2828 HIGHWAY 31 SOUTH
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603
Practice Address - Country:US
Practice Address - Phone:404-323-5039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty