Individual provider Active NPI

Angel Arturo Perez Sori, MD

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1124304746
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME 121644 Issued in FL
Practice address
3010 W Azeele St Ste 100
Tampa, FL 33609-3577
Phone
(813) 251-0194
Fax
(813) 254-0279
NPI assigned
Oct 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME 121644 FL Primary

Addresses

Primary practice location

3010 W Azeele St Ste 100
Tampa, FL 33609-3577

Mailing address

3010 W Azeele St Ste 100
Tampa, FL 33609-3577
Phone (813) 251-0194

Other identifiers 1

IdentifierTypeStateIssuer
014806300MedicaidFL

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
I20150604002437 FL Practitioner - Family Practice 1254652043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optumcare Florida, LLCGroup PAC ID 3072403476, 266 clinicians

Practice addresses (Care Compare)

1345 W Bay Dr
202 Optum Largo
Largo, FL 33770-2276
Phone (727) 559-0895

3010 W Azeele St
100 Optum Hyde Park
Tampa, FL 33609-3577
Phone (813) 251-0194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 121644FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optumcare Florida, LLC CurrentSince Jan 23, 2017 Accepting new patients
Optumcare Florida LLC Family Medicine CurrentSince Jan 23, 2017 Accepting new patients
Optumcare Florida Ci, LLC Past Accepting new patients
LBH Med Group LLC PastSince Jul 1, 2015 Accepting new patients

Locations

1345 West Bay Dr
Ste 202
Largo, FL 33770
Phone (727) 559-0895

10051 5th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 286-4093

3010 W Azeele St
Ste 100
Tampa, FL 33609
Phone (813) 251-0194

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: angel.perezsori@wellmed.eclinicaldirectplus.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1124304746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 W AZEELE ST STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093577",
            "telephone_number": "813-251-0194",
            "fax_number": "813-254-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 W AZEELE ST STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093577",
            "telephone_number": "813-251-0194",
            "fax_number": "813-254-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ SORI",
        "first_name": "ANGEL",
        "middle_name": "ARTURO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-27",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 121644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014806300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.