Derrick Alan Sovel

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT22771 Issued in FL

Practice address

2435 US Highway 19
Suite 100
Holiday, FL 34691-3903

Phone

(727) 939-2230

Fax

(727) 939-2245

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063435378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 BROKEN SOUND PKWY NW",
            "address_2": "225",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334873507",
            "telephone_number": "561-241-9300",
            "fax_number": "561-658-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 US HIGHWAY 19",
            "address_2": "SUITE 100",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346913903",
            "telephone_number": "727-939-2230",
            "fax_number": "727-939-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOVEL",
        "first_name": "DERRICK",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PT22771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA PROFESSIONAL LIC",
            "identifier": "PT22771",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Holiday, FL
• Providers in Holiday, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.