Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | ME81231 | FL |
NPI | 1023053279 |
---|---|
Provider Name | Roberto Von Sohsten |
First Address | Lake Worth, FL 33463 |
Second Address | Atlantis, FL 33462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 18/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
262231900 | (05) | FL |
G12229 | (02) |