Active NPI
Estanislao V Soria Jr., M.D.
- Family Medicine Physician
- Norfolk, VA
National Provider Identifier
1790843076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01040535
- Practice address
- 1035 Nider Blvd
Suite 100
Norfolk, VA 23521-2701 - Phone
- (757) 314-6802
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01040535 | VA | Primary |
Addresses
Primary practice location
1035 Nider Blvd
Suite 100
Norfolk, VA 23521-2701
Mailing address
4412 Clevhamm CMN
Virginia Beach, VA 23456-6319
Phone (757) 471-3674
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01040535 | VA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790843076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4412 CLEVHAMM CMN",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234566319",
"telephone_number": "757-471-3674",
"fax_number": "757-471-3673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 NIDER BLVD",
"address_2": "SUITE 100",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235212701",
"telephone_number": "757-314-6802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORIA",
"first_name": "ESTANISLAO",
"middle_name": "V",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "01040535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norfolk, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.