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NPI Code Detail

MEDICARE: MICHAEL SORE M.D.

MEDICARE: MICHAEL SORE 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
1207P00000XEmergency Medicine PhysicianME85141FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902883671
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL SORE M.D.
Provider Business Mailing Address
First Line : PO BOX 8405
Second Line :
City : TAMPA
State : FL
Zip : 33674-8405
Country : US
Telephone Number : 813-220-7594
Fax Number :
Provider Business Practice Location Address
First Line : 4004 N RIVERSIDE DR
Second Line :
City : TAMPA
State : FL
Zip : 33603-3212
Country : US
Telephone Number : 813-296-8300
Fax Number : 813-441-7669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 10/27/2023

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