Healthcare Provider Details

I. General information

NPI: 1962965533
Provider Name (Legal Business Name): ANASTASIA SOKHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. ANASTASIIA VOLODICHEVA

II. Dates (important events)

Enumeration Date: 04/10/2019
Last Update Date: 08/23/2025
Certification Date: 08/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 S HOUGHTON RD
TUCSON AZ
85748-7632
US

IV. Provider business mailing address

1324 LAKELAND HILLS BLVD ATTN: MANAGED CARE DEPT
LAKELAND FL
33805-4543
US

V. Phone/Fax

Practice location:
  • Phone: 520-543-6100
  • Fax:
Mailing address:
  • Phone: 863-687-1100
  • Fax: 863-630-6528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME156704
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: