Healthcare Provider Details

I. General information

NPI: 1619361052
Provider Name (Legal Business Name): NICOLE SORIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 ALBERT SABIN WAY MSB 1654 UC EMERGENCY MEDICINE
CINCINNATI OH
45267
US

IV. Provider business mailing address

3300 MERCY HEALTH BLVD
CINCINNATI OH
45211-1103
US

V. Phone/Fax

Practice location:
  • Phone: 513-558-8124
  • Fax:
Mailing address:
  • Phone: 513-215-1114
  • Fax: 513-558-5791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35136008
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number35136008
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number57.025954
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: