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General NPI Number Information
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NPI Number | 1073199154
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Entity Type | Organization
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Legal Business Name | DMS TELEHEALTH OKLAHOMA LLC
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Dates
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Enumeration Date | 03/20/2021
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Last Update Date | 03/20/2021
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Provider Practice Location Address
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Address Line | 3502 E GORE BLVD APT 4302
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City | LAWTON
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State | OK
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Zip | 73501-9012
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Country | US
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Telephone | 972-786-3602
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Fax |
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Provider Business Mailing Address
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Address Line | 2255 GLADES RD STE 321A
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City | BOCA RATON
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State | FL
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Zip | 33431-7383
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Country | US
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Telephone | 561-866-6444
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID SORIA
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Credential | MD
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Telephone | 561-866-6444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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