MEDICARE: MARIANNA SOFIA VOOLA

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	363A00000X	Physician Assistant	5721	OK

General Provider Information

NPI Number	:	1902788847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANNA SOFIA VOOLA

Provider Business Mailing Address
First Line	:	11912 S NORWOOD AVE STE 110
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-5547
Country	:	US
Telephone Number	:	918-943-5303
Fax Number	:	918-943-5302

Provider Business Practice Location Address
First Line	:	11912 S NORWOOD AVE STE 110
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-5547
Country	:	US
Telephone Number	:	918-943-5303
Fax Number	:	918-943-5302

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

Provider Enumeration Date	:	07/22/2025
Last Update Date	:	12/11/2025

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Directions to “ MARIANNA SOFIA VOOLA ” Practice Location

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