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General NPI Number Information
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NPI Number | 1497918601
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Entity Type | Individual
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Provider Name | SONAL SURA MD
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Gender | Female
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 8991 BRIGHTON LN
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-7505
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Country | US
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Telephone | 239-593-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 1931 CURLING AVE
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City | NAPLES
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State | FL
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Zip | 34109-1507
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Country | US
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Telephone |
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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 | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | 2655929
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | 143313
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License Number State | FL
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