Organization Active NPI

Soni Family Practice, PLLC

  • Family Medicine Physician
  • Davenport, FL
National Provider Identifier
1083957583
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SONI FAMILY PRACTICE, PLLC
Practice address
106 Park Place Blvd Ste C
Davenport, FL 33837-6868
Phone
(863) 588-4775
Fax
(863) 422-7664
NPI assigned
Apr 3, 2013
Last updated
Jan 14, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SONI FAMILY PRACTICE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Dr. Ambica Soni, MDNPI 1114191079
Title
Owner
Phone
(863) 588-4775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

106 Park Place Blvd Ste C
Davenport, FL 33837-6868

Mailing address

PO Box 1568
Davenport, FL 33836-1568
Phone (863) 588-4775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130425000711 FL Part B Supplier - Clinic/Group Practice 8224274840 Receives reassigned benefits from 20 practitioners
Practice locations: Poinciana, FL; Ocoee, FL; Lakeland, FL; Kissimmee, FL; Davenport, FL; Clermont, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2057880Soni Family Practice106 Park Place Blve Ste C, Davenport, FL 33837Certificate of waiverApr 24, 2027

National Provider Directory

National Provider Directory
Part of
Soni Family Practice PLLC

Locations

17075 Cagan Ridge Blvd
Ste 100
Clermont, FL 34714

106 Park Place Blvd
Ste C
Davenport, FL 33837
Phone (863) 422-7664

2217 North Blvd W
Ste B
Davenport, FL 33837
Phone (863) 547-0788

515 E Garden St
Ste B
Lakeland, FL 33805

2719 Maguire Rd
Ocoee, FL 34761

1060 Cypress Pkwy
Ste 101
Poinciana, FL 34759

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1083957583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1568",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338361568",
            "telephone_number": "863-588-4775",
            "fax_number": "863-588-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PARK PLACE BLVD STE C",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376868",
            "telephone_number": "863-588-4775",
            "fax_number": "863-422-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONI FAMILY PRACTICE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SONI FAMILY PRACTICE, PLLC",
        "enumeration_date": "2013-04-03",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "SONI",
        "authorized_official_first_name": "AMBICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-588-4775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.