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General NPI Number Information
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NPI Number | 1518755784
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Entity Type | Organization
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Legal Business Name | SOMA MEDICAL CENTER, PA #4
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1170 SW BAYSHORE BLVD STE 100
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City | PORT ST LUCIE
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State | FL
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Zip | 34983-2408
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Country | US
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Telephone | 561-281-4707
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Fax |
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Provider Business Mailing Address
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Address Line | 3255 FOREST HILL BLVD STE 103
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-5854
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Country | US
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Telephone | 561-281-4707
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADM
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Name | PAOLA A ALOMIA
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Credential |
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Telephone | 561-275-1155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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