Individual provider Active NPI

Sofia Montoya Martinez, ARNP

  • Pediatric Nurse Practitioner
  • Plant City, FL
National Provider Identifier
1447284302
Registry record updated Jan 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP2853362 Issued in FL
Practice address
502 N Mobley St
Plant City, FL 33563-2904
Phone
(813) 341-7450
Fax
(813) 341-7461
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP2853362 FL Primary

Addresses

Primary practice location

502 N Mobley St
Plant City, FL 33563-2904

Mailing address

13110 Elk Mountain Dr
Riverview, FL 33579-7182
Phone (813) 349-7568

Other identifiers 1

IdentifierTypeStateIssuer
302418100MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140919001046 FL Practitioner - Nurse Practitioner 1153540380 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Suncoast Community Health Centers Inc CurrentSince Jul 12, 2014 Accepting new patients
Suncoast Community Health Centers, Inc CurrentSince Jul 12, 2014 Accepting new patients
Suncoast Community Health Centers Inc Past Accepting new patients
Suncoast Community Health Centers Inc Past Accepting new patients

Locations

801 E Baker St
Plant City, FL 33563
Phone (813) 349-7649

502 N Mobley St
Plant City, FL 33563
Phone (813) 341-7450

13110 Elk Mountain Dr
Riverview, FL 33579
Phone (813) 349-7567

2814 14th Ave SE
Ruskin, FL 33570
Phone (813) 349-7800

Interoperability endpoints

  • Direct secure messaging: sofia.martinez@suncoastchc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1447284302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13110 ELK MOUNTAIN DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335797182",
            "telephone_number": "813-349-7568",
            "fax_number": "813-349-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 N MOBLEY ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335632904",
            "telephone_number": "813-341-7450",
            "fax_number": "813-341-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "SOFIA",
        "middle_name": "MONTOYA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP2853362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302418100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

Verify at the official NPI Registry.