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1083664932

NPI Code Detail

MEDICARE: DR. MARY C SOKOLOSKI MD

MEDICARE: DR. MARY C SOKOLOSKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0202X	Pediatric Cardiology Physician	MA 65375	NJ
2	2080P0202X	Pediatric Cardiology Physician	ME 100044	FL
3	2080P0202X	Pediatric Cardiology Physician	ME100044	FL
4	2080P0202X	Pediatric Cardiology Physician	MD-059406-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083664932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY C SOKOLOSKI MD

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-343-7490
Fax Number	:	239-343-5032

Provider Business Practice Location Address
First Line	:	22655 BAYSHORE RD STE 110
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33980-2005
Country	:	US
Telephone Number	:	941-235-4900
Fax Number	:	941-235-4901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	06/27/2024

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Directions to “ DR. MARY C SOKOLOSKI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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