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NPI Code Detail

MEDICARE: DR. REDA FAWZI SORIAL M.D.

MEDICARE:  DR. REDA FAWZI SORIAL  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
1208800000XUrology PhysicianME40821FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10748993OTHERFLCIGNA
21193473OTHERFLWELLCARE
3P0003171OTHERFLFLORIDA HEALTHCARE PLUS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5QMP000003722540OTHERFLMOLINA HEALTH
64008211OTHERFLAETNA
794305OTHERFLBC/BS
8P00900590OTHERFLRAILROAD MCR

General Provider Information

NPI Number : 1437189156
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REDA FAWZI SORIAL M.D.
Provider Business Mailing Address
First Line : 2234 COLONIAL BLVD
Second Line : ATTN: MANAGED CARE DEPT.
City : FORT MYERS
State : FL
Zip : 33907-1412
Country : US
Telephone Number : 239-931-7342
Fax Number : 239-931-7385
Provider Business Practice Location Address
First Line : 601 E SAMPLE RD
Second Line : SUITE 106
City : POMPANO BEACH
State : FL
Zip : 33064-4443
Country : US
Telephone Number : 954-785-0525
Fax Number : 954-943-1455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 05/06/2016

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Directions to “ DR. REDA FAWZI SORIAL M.D.” Practice Location

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