Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME24573 | FL |
Y | 111NI0900X | Internist | ME24573 | FL |
N | 207RN0300X | Nephrologist | ME24573 | FL |
NPI | 1033189337 |
---|---|
Provider Name | Robert Edgar Sonneborn |
First Address | Boca Raton, FL 33496-2658 |
Second Address | Boca Raton, FL 33496-2658 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 14/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
71942 | BCBS OF FL (01) | FL |
D58244 | (02) | |
P00413516 | RAILROAD MEDICARE (01) |