Healthcare Provider Details

I. General information

NPI: 1588932081
Provider Name (Legal Business Name): JAMES A SOTROP MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2011
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19021 N DALE MABRY HWY
LUTZ FL
33548-4982
US

IV. Provider business mailing address

PO BOX 1638
LUTZ FL
33548-1638
US

V. Phone/Fax

Practice location:
  • Phone: 813-961-5201
  • Fax: 813-948-8848
Mailing address:
  • Phone: 813-961-5201
  • Fax: 813-948-8848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP3279962
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME0041092
License Number StateFL

VIII. Authorized Official

Name: DR. JAMES A SOTROP
Title or Position: OWNER
Credential: MD
Phone: 813-961-5201