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NPI Code Detail

MEDICARE: SONI FAMILY PRACTICE, PLLC

MEDICARE: SONI FAMILY PRACTICE, PLLC
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
1207Q00000XFamily Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number : 1083957583
Entity Type Code : Organization
Provider Name (Legal Business Name) : SONI FAMILY PRACTICE, PLLC
Provider Business Mailing Address
First Line : PO BOX 1568
Second Line :
City : DAVENPORT
State : FL
Zip : 33836-1568
Country : US
Telephone Number : 863-588-4775
Fax Number : 863-588-4775
Provider Business Practice Location Address
First Line : 106 PARK PLACE BLVD STE C
Second Line :
City : DAVENPORT
State : FL
Zip : 33837-6868
Country : US
Telephone Number : 863-588-4775
Fax Number : 863-422-7664
Authorized Official
Title or Position : OWNER
Name : DR. AMBICA SONI
Credential : MD
Telephone Number : 863-588-4775
Provider Enumeration Date : 04/03/2013
Last Update Date : 01/14/2025

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Directions to “SONI FAMILY PRACTICE, PLLC ” Practice Location

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