Healthcare Provider Details

I. General information

NPI: 1073446324
Provider Name (Legal Business Name): VENUS SOSA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9160 FORUM CORPORATE PKWY STE 350
FORT MYERS FL
33905-7808
US

IV. Provider business mailing address

9160 FORUM CORPORATE PKWY STE 350
FORT MYERS FL
33905-7808
US

V. Phone/Fax

Practice location:
  • Phone: 954-372-5916
  • Fax: 954-994-2802
Mailing address:
  • Phone: 954-372-5916
  • Fax: 954-994-2802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberDO7432
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: