Healthcare Provider Details

I. General information

NPI: 1992999759
Provider Name (Legal Business Name): DINO VINCENT SORIANO SR. RN MSN HSA FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 CLOVER POINT CIR
GUYTON GA
31312-7134
US

IV. Provider business mailing address

171 CLOVER POINT CIR
GUYTON GA
31312-7134
US

V. Phone/Fax

Practice location:
  • Phone: 407-702-8095
  • Fax: 866-419-0621
Mailing address:
  • Phone: 407-702-8095
  • Fax: 866-419-0621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.19059
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN218133
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9254322
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN218133
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: