Healthcare Provider Details

I. General information

NPI: 1649946948
Provider Name (Legal Business Name): SONOLIFE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5015 HOLLYWOOD BLVD
HOLLYWOOD FL
33021-6515
US

IV. Provider business mailing address

1835 NE MIAMI GARDENS DR # 408
NORTH MIAMI BEACH FL
33179-5035
US

V. Phone/Fax

Practice location:
  • Phone: 305-714-2220
  • Fax:
Mailing address:
  • Phone: 305-714-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS SHIRLEY PUBIEN
Title or Position: SONOGRAPHER
Credential: RDCS
Phone: 305-434-0570