Healthcare Provider Details

I. General information

NPI: 1427445345
Provider Name (Legal Business Name): SOTERIA MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9150 SW 87TH AVE SUITE 213
MIAMI FL
33176-2319
US

IV. Provider business mailing address

9150 SW 87TH AVE SUITE 213
MIAMI FL
33176-2319
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-4447
  • Fax: 305-248-6320
Mailing address:
  • Phone: 305-595-4447
  • Fax: 305-248-6320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number10D2086850
License Number StateFL

VIII. Authorized Official

Name: DR. JEFFREY KENT RAINES
Title or Position: PRESIDENT AND CEO
Credential: MD, PHD
Phone: 305-595-4447