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General NPI Number Information
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NPI Number | 1003761842
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Entity Type | Organization
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Legal Business Name | SOMA MEDICAL CENTER PA 15
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Dates
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Enumeration Date | 02/26/2026
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Last Update Date | 02/26/2026
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Provider Practice Location Address
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Address Line | 2504 ACORN STREET SUITE A
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City | FORT PIERCE
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State | FL
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Zip | 34947
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Country | US
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Telephone | 772-837-7800
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Fax | 772-837-7801
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Provider Business Mailing Address
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Address Line | 2504 ACORN STREET SUITE A
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City | FORT PIERCE
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State | FL
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Zip | 34947
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Country | US
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Telephone | 772-837-7800
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Fax | 772-837-7801
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Authorized Official
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Title or Position | VP
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Name | ANDRES FLOREZ
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Credential |
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Telephone | 561-964-4577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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