Healthcare Provider Details
I. General information
NPI: 1699065375
Provider Name (Legal Business Name): CAROLINE PORYLES SOYKA D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/14/2011
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1002 S OLD DIXIE HWY STE 201
JUPITER FL
33458-7202
US
IV. Provider business mailing address
9500 S DADELAND BLVD STE 200
MIAMI FL
33156-2866
US
V. Phone/Fax
- Phone: 561-744-2200
- Fax: 561-744-3083
- Phone: 786-530-3820
- Fax: 305-675-3378
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | OS17588 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: