| Soma Medical Center Pa #5 | |
|
330 S Dixie Hwy Lake Worth FL 33460-4400 | |
| (561) 227-3993 | |
| (561) 855-4308 |
| Full Name | Soma Medical Center Pa #5 |
|---|---|
| Speciality | Internal Medicine |
| Location | 330 S Dixie Hwy, Lake Worth, Florida |
| Authorized Official Name and Position | Rafael O Nunez (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5619644577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soma Medical Center Pa #5 330 S Dixie Hwy Lake Worth FL 33460-4400 Ph: (561) 227-3993 | Soma Medical Center Pa #5 330 S Dixie Hwy Lake Worth FL 33460-4400 Ph: (561) 227-3993 |
| NPI Number | 1063754588 |
|---|---|
| Provider Enumeration Date | 03/22/2013 |
| Last Update Date | 09/26/2023 |
| Medicare PECOS PAC ID | 4688039605 |
|---|---|
| Medicare Enrollment ID | O20230426002849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063754588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Rafael Orlando Nunez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043208895 PECOS PAC ID: 5395753552 Enrollment ID: I20110121001036 |
| Provider Name | Maria Del Pilar Roa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407407695 PECOS PAC ID: 3971933805 Enrollment ID: I20200416003981 |
| Provider Name | Ihosvany Armengol |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285267161 PECOS PAC ID: 2062803752 Enrollment ID: I20220107000968 |
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