MEDICARE: SOVI JOSEPH MD PA

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	207R00000X	Internal Medicine Physician	ME77185	FL
2	207RG0100X	Gastroenterology Physician	ME77185	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	49257	OTHER	FL	BCBS FL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376626937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOVI JOSEPH MD PA

Provider Business Mailing Address
First Line	:	3440 TAMIAMI TRL
Second Line	:	SUITE 1
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-8134
Country	:	US
Telephone Number	:	941-258-9500
Fax Number	:	941-258-9501

Provider Business Practice Location Address
First Line	:	3440 TAMIAMI TRL
Second Line	:	SUITE 1
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-8134
Country	:	US
Telephone Number	:	941-258-9500
Fax Number	:	941-258-9501

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	12/01/2022

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Directions to “ SOVI JOSEPH MD PA” Practice Location

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