| Independence Medical LLC | |
|
2260 Vista Rd Fort Mill SC 29708 | |
| (803) 556-5341 | |
| (803) 784-7994 |
| Full Name | Independence Medical LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2260 Vista Rd, Fort Mill, South Carolina |
| Authorized Official Name and Position | Hsiao Soriano (OWNER/SOLE MEMBER) |
| Authorized Official Contact | 8035565341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Medical LLC 5527 Arden Mill Dr Ste 103-115 Fort Mill SC 29715-6974 Ph: (803) 556-5341 | Independence Medical LLC 2260 Vista Rd Fort Mill SC 29708 Ph: (803) 556-5341 |
| NPI Number | 1700749488 |
|---|---|
| Provider Enumeration Date | 12/08/2025 |
| Last Update Date | 07/01/2026 |
| Certification Date | 07/01/2026 |
| Medicare PECOS PAC ID | 2860971520 |
|---|---|
| Medicare Enrollment ID | O20260212001100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700749488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Hsiao L Soriano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366737132 PECOS PAC ID: 3173740529 Enrollment ID: I20161014001866 |
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