MEDICARE: SONI PIOUS

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	183500000X	Pharmacist	PS36535	FL

General Provider Information

NPI Number	:	1386913234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONI PIOUS

Provider Business Mailing Address
First Line	:	1739 QUEEN PALM WAY
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34288-8656
Country	:	US
Telephone Number	:	941-286-4623
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 KINGS HWY
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33980-4214
Country	:	US
Telephone Number	:	941-764-8444
Fax Number	:

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

Provider Enumeration Date	:	12/22/2011
Last Update Date	:	12/22/2011

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Directions to “ SONI PIOUS ” Practice Location

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