Provider Demographics
NPI:1053137885
Name:SONI FAMILY PRACTICE PLLC
Entity type:Organization
Organization Name:SONI FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-588-4775
Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-1568
Mailing Address - Country:US
Mailing Address - Phone:863-588-4775
Mailing Address - Fax:863-588-4775
Practice Address - Street 1:221 FRONTAGE RD UNIT G
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2431
Practice Address - Country:US
Practice Address - Phone:863-588-4775
Practice Address - Fax:863-422-7664
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SONI FAMILY PRACTICE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-26
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty