Basic Information
| Provider Information | |||||||||
| NPI: | 1710193032 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOSA | ||||||||
| FirstName: | MARIE | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1120 NW 14TH ST | ||||||||
| Address2: | SUITE 809 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052433583 | ||||||||
| FaxNumber: | 3052433506 | ||||||||
| Practice Location | |||||||||
| Address1: | 1120 NW 14TH ST | ||||||||
| Address2: | SUITE 809 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052433583 | ||||||||
| FaxNumber: | 3052433506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2007 | ||||||||
| LastUpdateDate: | 08/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME128340 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | ME128340 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.