Sonenblum, Michael

Sonenblum, Michael is an individual health care provider with primary practice located at 1850 Sw Fountainview Blvd Suite 105, Port St Lucie FL 34986-3443. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Sonenblum, Michael can be contacted via phone (772) 336-2818.

Contact Information

Primary practice address
1850 Sw Fountainview Blvd Suite 105 Port St Lucie FL 34986-3443
Fax: (772) 336-5313
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME57821 Florida

Profile Details

NPI number 1275522690
LBN Legal business name Sonenblum, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Oct 9th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275522690 NPPES
Florida MEDICAID 064614800

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