Individual provider Active NPI

Sora Song

  • Family Nurse Practitioner
  • Seminole, FL
National Provider Identifier
1255945887
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F342562 Issued in NY
Practice address
8477 Parkwood Blvd
Seminole, FL 33777-2711
Phone
(727) 221-8563
NPI assigned
Sep 1, 2020
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F342562 NY Primary

Addresses

Primary practice location

8477 Parkwood Blvd
Seminole, FL 33777-2711

Mailing address

8477 Parkwood Blvd
Seminole, FL 33777-2711
Phone (727) 221-8563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F342562NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf View Medical & Urgent Care Inc Current Accepting new patients
Primary Care Walk in Clinic,PLLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

6329 State Road 54
New Prt Rchy, FL 34653
Phone (727) 844-5555

11123 County Line Rd
Spring Hill, FL 34609
Phone (352) 666-5555

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABCCBA

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1255945887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8477 PARKWOOD BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337772711",
            "telephone_number": "727-221-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8477 PARKWOOD BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337772711",
            "telephone_number": "727-221-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "SORA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

Verify at the official NPI Registry.