Healthcare Provider Details
I. General information
NPI: 1881990802
Provider Name (Legal Business Name): SOMA MEDICAL CENTER, PA 2
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/09/2011
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3145 S CONGRESS AVE STE B
PALM SPRINGS FL
33461-2553
US
IV. Provider business mailing address
3145 S CONGRESS AVE STE B
PALM SPRINGS FL
33461-2553
US
V. Phone/Fax
- Phone: 561-360-2034
- Fax: 561-360-2650
- Phone: 561-360-2034
- Fax: 561-360-2650
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME101616 |
| License Number State | FL |
VIII. Authorized Official
Name: MRS.
PAOLA
A
ALOMI
Title or Position: OFFICE
Credential:
Phone: 561-360-2034