Healthcare Provider Details

I. General information

NPI: 1699692996
Provider Name (Legal Business Name): SOUROUGNANI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3248 NW 36TH ST
LAUDERDALE LAKES FL
33309-5542
US

IV. Provider business mailing address

3248 NW 36TH ST
LAUDERDALE LAKES FL
33309-5542
US

V. Phone/Fax

Practice location:
  • Phone: 432-243-4243
  • Fax:
Mailing address:
  • Phone: 432-243-4243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: PIARI DJIBO
Title or Position: MANAGER
Credential:
Phone: 432-243-4243