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General NPI Number Information
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NPI Number | 1487189585
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Entity Type | Organization
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Legal Business Name | WELLINGTON NEUROLOGIC SPECIALISTS LLC
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 950 PENINSULA CORPORATE CIR STE 2000
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City | BOCA RATON
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State | FL
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Zip | 33487-1378
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Country | US
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Telephone | 817-451-4208
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Fax | 817-563-3699
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Provider Business Mailing Address
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Address Line | PO BOX 24619
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City | FORT WORTH
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State | TX
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Zip | 76124-1619
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Country | US
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Telephone | 817-451-4208
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Fax | 817-563-3699
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. DAVID M SORIA
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Credential | MD
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Telephone | 817-451-4208
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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 | ME70823
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License Number State | FL
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