Healthcare Provider Details

I. General information

NPI: 1528158458
Provider Name (Legal Business Name): DANIEL L. SONTHEIMER M.D., MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 BAPTIST WAY
PENSACOLA FL
32503-2254
US

IV. Provider business mailing address

123 BAPTIST WAY
PENSACOLA FL
32503-2254
US

V. Phone/Fax

Practice location:
  • Phone: 448-227-8478
  • Fax:
Mailing address:
  • Phone: 850-469-7406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2003018088
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME118202
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME118202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: