MEDICARE: DR. SONIA ISABEL MILLAN PINZON MD

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	207QS0010X	Sports Medicine (Family Medicine) Physician	ME119542	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588980346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONIA ISABEL MILLAN PINZON MD

Provider Business Mailing Address
First Line	:	120 CYPRESS EDGE DR STE 207
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-8454
Country	:	US
Telephone Number	:	386-586-1910
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 CYPRESS EDGE DR STE 207
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-8454
Country	:	US
Telephone Number	:	386-586-1910
Fax Number	:	386-586-4411

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

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	07/19/2019

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Directions to “ DR. SONIA ISABEL MILLAN PINZON MD” Practice Location

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