MEDICARE: LOUIS E SOSCIA M.D.

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	207V00000X	Obstetrics & Gynecology Physician	ME21968	FL

General Provider Information

NPI Number	:	1336394824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS E SOSCIA M.D.

Provider Business Mailing Address
First Line	:	6340 WATERCREST WAY
Second Line	:	SUITE 201
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-5216
Country	:	US
Telephone Number	:	941-780-3409
Fax Number	:	941-388-0714

Provider Business Practice Location Address
First Line	:	6340 WATERCREST WAY
Second Line	:	SUITE 201
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-5216
Country	:	US
Telephone Number	:	941-780-3409
Fax Number	:	941-388-0714

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

Provider Enumeration Date	:	11/25/2008
Last Update Date	:	11/25/2008

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