Healthcare Provider Details

I. General information

NPI: 1114659687
Provider Name (Legal Business Name): SORELL PAGLIARA LM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 NE 1ST ST STE B
GAINESVILLE FL
32601-5710
US

IV. Provider business mailing address

10213 NW 6TH PL
GAINESVILLE FL
32607-1337
US

V. Phone/Fax

Practice location:
  • Phone: 352-377-3879
  • Fax:
Mailing address:
  • Phone: 352-246-3936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW336
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: