Paul D Sovran Md Pa | |
211 Ruby Ave Kissimmee FL 34741-5679 | |
(407) 847-3333 | |
(407) 847-8622 |
Full Name | Paul D Sovran Md Pa |
---|---|
Speciality | Internal Medicine |
Location | 211 Ruby Ave, Kissimmee, Florida |
Authorized Official Name and Position | Paul David Sovran (OWNER) |
Authorized Official Contact | 4078473333 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Paul D Sovran Md Pa 211 Ruby Ave Kissimmee FL 34741-5679 Ph: (407) 847-3333 | Paul D Sovran Md Pa 211 Ruby Ave Kissimmee FL 34741-5679 Ph: (407) 847-3333 |
NPI Number | 1588979488 |
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Provider Enumeration Date | 08/16/2010 |
Last Update Date | 08/16/2010 |
Medicare PECOS PAC ID | 2769666213 |
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Medicare Enrollment ID | O20110407000928 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588979488 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | 037109 (Florida) | Primary |
Provider Name | Paul Sovran |
---|---|
Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1093710097 PECOS PAC ID: 4486838935 Enrollment ID: I20110407000945 |
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