Healthcare Provider Details

I. General information

NPI: 1851325138
Provider Name (Legal Business Name): MICHAEL ROBERT SOVIS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 04/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 MILITARY TRL SUITE 303
JUPITER FL
33458-7801
US

IV. Provider business mailing address

2055 MILITARY TRL SUITE 303
JUPITER FL
33458-7801
US

V. Phone/Fax

Practice location:
  • Phone: 561-427-0860
  • Fax: 561-427-0870
Mailing address:
  • Phone: 561-427-0860
  • Fax: 561-427-0870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberARNP2803282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: