Provider Demographics
NPI:1053897785
Name:SORAYA, SOHEILA SHEILA (PHARMD)
Entity type:Individual
Prefix:
First Name:SOHEILA
Middle Name:SHEILA
Last Name:SORAYA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10769 N FRANK LLOYD WRIGHT BLVD STE A100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-2670
Mailing Address - Country:US
Mailing Address - Phone:480-443-4656
Mailing Address - Fax:
Practice Address - Street 1:10769 N FRANK LLOYD WRIGHT BLVD STE A100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-2670
Practice Address - Country:US
Practice Address - Phone:480-443-4656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS009159183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist