MEDICARE: SOFRONIO SORIANO PROFESSIONAL CORPORATION

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	208D00000X	General Practice Physician
2	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1093878548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOFRONIO SORIANO PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 30844
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89173-0844
Country	:	US
Telephone Number	:	702-750-2837
Fax Number	:	702-750-2847

Provider Business Practice Location Address
First Line	:	4425 S JONES BLVD STE D3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3370
Country	:	US
Telephone Number	:	702-750-2837
Fax Number	:	702-750-2847

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	HENDRICA SORIANO
Credential	:
Telephone Number	:	702-750-2837

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	10/07/2025

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Directions to “SOFRONIO SORIANO PROFESSIONAL CORPORATION ” Practice Location

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