Healthcare Provider Details

I. General information

NPI: 1366776510
Provider Name (Legal Business Name): SOBE WELL, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2009
Last Update Date: 09/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3121 PONCE DE LEON BLVD
CORAL GABLES FL
33134-6816
US

IV. Provider business mailing address

3121 PONCE DE LEON BLVD
CORAL GABLES FL
33134-6816
US

V. Phone/Fax

Practice location:
  • Phone: 305-598-6767
  • Fax: 305-598-6766
Mailing address:
  • Phone: 305-598-6767
  • Fax: 305-598-6766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCH6620
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberCH6620
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH6620
License Number StateFL

VIII. Authorized Official

Name: PATRECE ADELE FRISBEE
Title or Position: SOLE PROPRIETOR
Credential: D.C.
Phone: 305-598-6767