MEDICARE: DR. DEAN L. SORRENTO DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213EP1101X	Primary Podiatric Medicine Podiatrist	PO4427	FL
2	213ES0131X	Foot Surgery Podiatrist	PO4427	FL
3	213E00000X	Podiatrist	PO4427	FL
4	213ES0000X	Sports Medicine Podiatrist	PO4427	FL
5	213ES0103X	Foot & Ankle Surgery Podiatrist	PO4427	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	01229701	OTHER	PA	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	OKZQ5	OTHER	FL	BCBS
5	869667	OTHER	PW	BLUE SHIELD

General Provider Information

NPI Number	:	1487654166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEAN L. SORRENTO DPM

Provider Business Mailing Address
First Line	:	15815 SHADDOCK DR STE 130
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-5773
Country	:	US
Telephone Number	:	813-400-1140
Fax Number	:	813-870-3569

Provider Business Practice Location Address
First Line	:	33920 US HIGHWAY 19 N STE 200
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-2373
Country	:	US
Telephone Number	:	727-683-8012
Fax Number	:	407-671-4155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	02/03/2026

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Directions to “ DR. DEAN L. SORRENTO DPM” Practice Location

Language	Start Address	Practice Location

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