MEDICARE: SONIA DEL PILAR PASTAS MORAN

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	122300000X	Dentist	DN27251	FL

General Provider Information

NPI Number	:	1609500933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA DEL PILAR PASTAS MORAN

Provider Business Mailing Address
First Line	:	3103 SHOMA DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33414-4366
Country	:	US
Telephone Number	:	561-800-6008
Fax Number	:

Provider Business Practice Location Address
First Line	:	3103 SHOMA DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33414-4366
Country	:	US
Telephone Number	:	561-800-6008
Fax Number	:

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

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	07/12/2022

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Directions to “ SONIA DEL PILAR PASTAS MORAN ” Practice Location

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