| Paul D Sovran MD PA | |
|
211 Ruby Ave Kissimmee FL 34741-5679 | |
| (407) 847-3333 | |
| (407) 847-8622 |
| Full Name | Paul D Sovran MD PA |
|---|---|
| Speciality | Internal Medicine |
| Location | 211 Ruby Ave, Kissimmee, Florida |
| Authorized Official Name and Position | Paul David Sovran (OWNER) |
| Authorized Official Contact | 4078473333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul D Sovran MD PA 211 Ruby Ave Kissimmee FL 34741-5679 Ph: (407) 847-3333 | Paul D Sovran MD PA 211 Ruby Ave Kissimmee FL 34741-5679 Ph: (407) 847-3333 |
| NPI Number | 1588979488 |
|---|---|
| Provider Enumeration Date | 08/16/2010 |
| Last Update Date | 08/16/2010 |
| Medicare PECOS PAC ID | 2769666213 |
|---|---|
| Medicare Enrollment ID | O20110407000928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588979488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 037109 (Florida) | Primary |
| Provider Name | Paul Sovran |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1093710097 PECOS PAC ID: 4486838935 Enrollment ID: I20110407000945 |
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