Healthcare Provider Details

I. General information

NPI: 1588169452
Provider Name (Legal Business Name): KARINA SOMOHANO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2018
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7593 W BOYNTON BEACH BLVD STE 104
BOYNTON BEACH FL
33437-6161
US

IV. Provider business mailing address

PO BOX 947665
ATLANTA GA
30394-7665
US

V. Phone/Fax

Practice location:
  • Phone: 561-732-8005
  • Fax:
Mailing address:
  • Phone: 772-283-2020
  • Fax: 772-219-7924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME162471
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License NumberME162471
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: