Provider Demographics
NPI:1730921412
Name:SOMA MEDICAL CENTER, P.A.
Entity type:Organization
Organization Name:SOMA MEDICAL CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMORANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-202-6231
Mailing Address - Street 1:3145 S CONGRESS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2553
Mailing Address - Country:US
Mailing Address - Phone:561-559-2371
Mailing Address - Fax:561-530-4540
Practice Address - Street 1:3145 S CONGRESS AVE STE A
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2553
Practice Address - Country:US
Practice Address - Phone:561-559-2371
Practice Address - Fax:561-530-4540
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOMA MEDICAL CENTER, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty