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NPI Code Detail

MEDICARE: JUSTIN SOBRINO

MEDICARE: JUSTIN SOBRINO
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
12086S0120XPediatric Surgery Physician99128GA

General Provider Information

NPI Number : 1396058871
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN SOBRINO
Provider Business Mailing Address
First Line : 5461 MERIDIAN MARK RD STE 570
Second Line :
City : ATLANTA
State : GA
Zip : 30342-2807
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5461 MERIDIAN MARK RD STE 570
Second Line :
City : ATLANTA
State : GA
Zip : 30342-2807
Country : US
Telephone Number : 404-785-6895
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2010
Last Update Date : 03/28/2024

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Directions to “ JUSTIN SOBRINO ” Practice Location

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