Individual provider Active NPI

Ambica Soni, MD

  • Family Medicine Physician
  • Davenport, FL
National Provider Identifier
1114191079
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME115157 Issued in FL
Practice address
106 Park Place Blvd Ste C
Davenport, FL 33837-6868
Phone
(863) 588-4775
Fax
(863) 422-7664
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 247497 MA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME115157 FL Primary

Addresses

Primary practice location

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

Mailing address

PO Box 878
Davenport, FL 33836-0878
Phone (689) 223-3898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130425000715 FL Practitioner - Family Practice 2567634710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Soni Family Practice PLLCGroup PAC ID 8224274840, 11 clinicians

Practice addresses (Care Compare)

106 Park Place Blvd
Suite C
Davenport, FL 33837-6868
Phone (863) 588-4775

2705 Maguire Rd
Ocoee, FL 34761-4797
Phone (863) 588-4775

515 E Garden St
Suite B
Lakeland, FL 33805-4615
Phone (863) 588-4775

907 N Central Ave
Suite a
Kissimmee, FL 34741-5002
Phone (863) 588-4775

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME115157FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SFP PC Holdings, Inc. CurrentSince Jun 15, 2025 Accepting new patients
Soni Family Practice, PLLC Family Medicine CurrentSince Apr 9, 2013 Accepting new patients
Soni Family Practice, PLLC Family Medicine Past Accepting new patients
Soni Family Practice, PLLC Family Medicine Past Accepting new patients
Soni Family Practice, PLLC Family Medicine Past Accepting new patients
Soni Family Practice, PLLC Family Medicine Past Accepting new patients
Soni Family Practice, PLLC Family Medicine Past Accepting new patients
Soni Family Practice, PLLC Family Medicine PastSince Dec 1, 2024 Accepting new patients

Locations

17075 Cagan Ridge Blvd
Ste 100
Clermont, FL 34714

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

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

2705 Maguire Rd
Ocoee, FL 34761
Phone (407) 574-2880

1060 Cypress Pkwy
Unit 101
Poinciana, FL 34759

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ambica.soni.1@6807.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1114191079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 878",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338360878",
            "telephone_number": "689-223-3898",
            "fax_number": "689-223-3898"
        },
        {
            "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": {
        "last_name": "SONI",
        "first_name": "AMBICA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "247497",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME115157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.