Healthcare Provider Details

I. General information

NPI: 1942118567
Provider Name (Legal Business Name): SONI FAMILY PRACTICE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 PALM ST STE 1
COCOA FL
32927-5100
US

IV. Provider business mailing address

PO BOX 878
DAVENPORT FL
33836-0878
US

V. Phone/Fax

Practice location:
  • Phone: 321-639-4243
  • Fax: 321-639-4266
Mailing address:
  • Phone: 689-223-3898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMBICA SONI
Title or Position: CMO
Credential:
Phone: 352-502-0199