Healthcare Provider Details

I. General information

NPI: 1043607161
Provider Name (Legal Business Name): MARY LOUIS SOSCIA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY SOSCIA LYONS

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3945 CLARK RD
SARASOTA FL
34233-2364
US

IV. Provider business mailing address

5426 BAY CENTER DR SUITE 300
TAMPA FL
33609-3444
US

V. Phone/Fax

Practice location:
  • Phone: 941-923-2500
  • Fax: 941-923-2520
Mailing address:
  • Phone: 813-569-6500
  • Fax: 813-864-4030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9204002
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: