Healthcare Provider Details

I. General information

NPI: 1366397192
Provider Name (Legal Business Name): SOMA MEDICAL CENTER, PA #4
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 ACORN ST STE B
FORT PIERCE FL
34947-4746
US

IV. Provider business mailing address

2504 ACORN ST STE B
FORT PIERCE FL
34947-4746
US

V. Phone/Fax

Practice location:
  • Phone: 772-837-7800
  • Fax: 772-837-7801
Mailing address:
  • Phone: 772-837-7800
  • Fax: 772-837-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: PAOLA A ALOMIA
Title or Position: PRACTICE ADM
Credential:
Phone: 561-275-1155