Provider Demographics
NPI:1528891850
Name:SOROKA, JAMIE L (DNP-PMHNP)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:SOROKA
Suffix:
Gender:F
Credentials:DNP-PMHNP
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:BOOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1351 S DUNCAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3611
Mailing Address - Country:US
Mailing Address - Phone:727-254-6841
Mailing Address - Fax:
Practice Address - Street 1:1351 S DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3611
Practice Address - Country:US
Practice Address - Phone:727-254-6841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033635363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health