MEDICARE: EDGAR SOSA D.O.

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	208200000X	Plastic Surgery Physician	OS-14580	FL
2	2086S0122X	Plastic and Reconstructive Surgery Physician	OS-14580	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	:	1699938472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDGAR SOSA D.O.

Provider Business Mailing Address
First Line	:	5070 HIGHWAY A1A STE A
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-1229
Country	:	US
Telephone Number	:	772-234-3700
Fax Number	:	772-234-3770

Provider Business Practice Location Address
First Line	:	5070 HIGHWAY A1A STE A
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-1229
Country	:	US
Telephone Number	:	772-234-3700
Fax Number	:	772-234-3770

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

Provider Enumeration Date	:	07/02/2008
Last Update Date	:	02/18/2025

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Directions to “ EDGAR SOSA D.O.” Practice Location

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