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General NPI Number Information
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NPI Number | 1659630671
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Entity Type | Individual
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Provider Name | AMI SONIA MODH D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/11/2012
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 14055 RIVEREDGE DR STE 250
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City | TAMPA
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State | FL
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Zip | 33637-2141
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Country | US
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Telephone | 813-929-5451
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Fax |
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Provider Business Mailing Address
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Address Line | 14055 RIVEREDGE DR STE 250
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City | TAMPA
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State | FL
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Zip | 33637-2141
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Country | US
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Telephone | 813-929-5451
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | OS12135
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | OT012696
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | P3932
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License Number State | TX
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