Healthcare Provider Details
I. General information
NPI: 1033790050
Provider Name (Legal Business Name): SOMA MEDICAL CENTER PA 7
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/20/2021
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4777 N CONGRESS AVE
BOYNTON BEACH FL
33426-7941
US
IV. Provider business mailing address
4777 N CONGRESS AVE
BOYNTON BEACH FL
33426-7941
US
V. Phone/Fax
- Phone: 561-281-4707
- Fax:
- Phone: 561-328-8712
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAOLA
A
ALOMIA
Title or Position: PRACTICE ADM
Credential:
Phone: 561-281-4707