MEDICARE: SONOLIFE CARE LLC

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	2085U0001X	Diagnostic Ultrasound Physician

General Provider Information

NPI Number	:	1649946948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SONOLIFE CARE LLC

Provider Business Mailing Address
First Line	:	1835 NE MIAMI GARDENS DR # 408
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-5035
Country	:	US
Telephone Number	:	305-714-2220
Fax Number	:

Provider Business Practice Location Address
First Line	:	5015 HOLLYWOOD BLVD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6515
Country	:	US
Telephone Number	:	305-714-2220
Fax Number	:

Authorized Official
Title or Position	:	SONOGRAPHER
Name	:	MISS SHIRLEY PUBIEN
Credential	:	RDCS
Telephone Number	:	305-434-0570

Provider Enumeration Date	:	08/18/2021
Last Update Date	:	08/18/2021

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Directions to “SONOLIFE CARE LLC ” Practice Location

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