Sourial Morris Sourial MD

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

OS11425 Issued in FL

Legal business name

SOURIAL MORRIS SOURIAL MD

Doing business as

Sourial FP and Pain Care, P.A.

Practice address

16670 S US Highway 441
Suite 103
Summerfield, FL 34491-8683

Phone

(352) 347-1608

Fax

(888) 241-3383

NPI assigned

Sep 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Sourial Morris Sourial, D.O.

Title

President

Phone

(352) 347-1608

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Sourial FP and Pain Care, P.A. Doing business as

Locations

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1356743876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16670 S US HIGHWAY 441",
            "address_2": "SUITE 103",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918683",
            "telephone_number": "352-347-1608",
            "fax_number": "888-241-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16670 S US HIGHWAY 441",
            "address_2": "SUITE 103",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344918683",
            "telephone_number": "352-347-1608",
            "fax_number": "888-241-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURIAL MORRIS SOURIAL MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "SOURIAL",
        "authorized_official_first_name": "SOURIAL",
        "authorized_official_middle_name": "MORRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-347-1608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "OS11425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000229116",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "151441",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD FLORIDA",
            "identifier": "14H1P",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sourial FP and Pain Care, P.A.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Medical Specialty Clinic/Center in Summerfield, FL
• Providers in Summerfield, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.