Provider Demographics
NPI:1982709812
Name:JOSEPH, SONNY VALOORAN (MD)
Entity Type:Individual
Prefix:
First Name:SONNY
Middle Name:VALOORAN
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 TURKEY LAKE ROAD
Mailing Address - Street 2:204
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8015
Mailing Address - Country:US
Mailing Address - Phone:407-354-5290
Mailing Address - Fax:407-370-3411
Practice Address - Street 1:9430 TURKEY LAKE ROAD
Practice Address - Street 2:204
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8015
Practice Address - Country:US
Practice Address - Phone:407-354-5290
Practice Address - Fax:407-370-3411
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME576632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
11456Medicare ID - Type Unspecified
E58549Medicare UPIN