Healthcare Provider Details

I. General information

NPI: 1871858043
Provider Name (Legal Business Name): RICHARD URBANO GARCIA SORIANO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 N DRUID HILLS RD NE
ATLANTA GA
30329-3117
US

IV. Provider business mailing address

2970 BRANDYWINE RD STE 125
ATLANTA GA
30341-5528
US

V. Phone/Fax

Practice location:
  • Phone: 404-256-2593
  • Fax:
Mailing address:
  • Phone: 404-256-2593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301102029
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number4301102029
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number89691
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: