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General NPI Number Information
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NPI Number | 1194816041
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Entity Type | Individual
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Provider Name | JAVIER ENID SOSA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 15661 SAN CARLOS BLVD UNIT 2
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City | FORT MYERS
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State | FL
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Zip | 33908-2797
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Country | US
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Telephone | 239-433-4014
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Fax | 239-481-6247
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Provider Business Mailing Address
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Address Line | 2675 WINKLER AVE STE 200
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City | FORT MYERS
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State | FL
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Zip | 33901-9328
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Country | US
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Telephone | 877-856-3774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME59779
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License Number State | FL
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