Provider Demographics
NPI:1982612891
Name:SOTIRESCU, ALICIA CAMPS (MD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:CAMPS
Last Name:SOTIRESCU
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 1:8175 NW 12TH ST
Mailing Address - Street 2:3RD FLOOR SUITE 306
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1828
Mailing Address - Country:US
Mailing Address - Phone:786-845-0164
Mailing Address - Fax:305-470-5846
Practice Address - Street 1:8175 NW 12TH ST
Practice Address - Street 2:SUITE 306
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1828
Practice Address - Country:US
Practice Address - Phone:786-845-0164
Practice Address - Fax:305-470-5846
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPHC20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000488900Medicaid
FL000488900Medicaid