Individual provider Active NPI

Luis D'Montique Soriano, PA-C

  • Medical Physician Assistant
  • Pembroke Pines, FL
National Provider Identifier
1629386396
Registry record updated Sep 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9105637 Issued in FL
Practice address
1220 Bel Aire Dr W
Pembroke Pines, FL 33027-2220
Phone
(786) 316-1211
NPI assigned
Sep 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9105637 FL Primary

Addresses

Primary practice location

1220 Bel Aire Dr W
Pembroke Pines, FL 33027-2220

Mailing address

1220 Bel Aire Dr W
Pembroke Pines, FL 33027-2220
Phone (786) 316-1211

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
I20120917000829 FL Practitioner - Physician Assistant 8123276136 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solantic/South Florida LLCGroup PAC ID 5496762171, 27 clinicians

Practice addresses (Care Compare)

1611 S Federal Hwy
Pompano Beach, FL 33062-7514
Phone (954) 580-4001

9035 Pines Blvd
Pembroke Pines, FL 33024-6440
Phone (954) 378-0333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System /Sunbelt, Inc. CurrentSince Aug 10, 2020 Accepting new patients
Urgent Care Centers of Brevard County LLC CurrentSince Sep 28, 2020 Accepting new patients
Urgent Care Centers of Brevard County LLC CurrentSince Sep 28, 2020 Accepting new patients
Adventist Health System/ Sunbelt, Inc. CurrentSince Aug 10, 2020 Accepting new patients
Emergency Physician Solutions of South Florida, LLC PastSince Mar 1, 2020 Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

105 S Banana River Blvd
Cocoa Beach, FL 32931
Phone (321) 783-3362

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285372800000",
    "number": "1629386396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 BEL AIRE DR W",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330272220",
            "telephone_number": "786-316-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 BEL AIRE DR W",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330272220",
            "telephone_number": "786-316-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORIANO",
        "first_name": "LUIS",
        "middle_name": "D'MONTIQUE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.