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General NPI Number Information
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NPI Number | 1508191743
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Entity Type | Individual
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Provider Name | ALEXEY VASILIEVICH SOROKIN MD
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Gender | Male
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Dates
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Enumeration Date | 10/06/2009
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 1600 S ANDREWS AVE
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City | FT LAUDERDALE
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State | FL
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Zip | 33316-2510
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Country | US
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Telephone | 505-248-1800
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Fax | 505-248-1917
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Provider Business Mailing Address
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Address Line | 500 UNSER BLVD. S.E. SUITE 201
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City | RIO RANCHO
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State | NM
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Zip | 87124
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Country | US
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Telephone | 505-248-1800
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Fax | 505-248-1917
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 043726
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD2009-0792
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME117777
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License Number State | FL
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