Sorenson, Demittre Andre Anthony

Sorenson, Demittre Andre Anthony is an sole proprietor health care provider with primary practice located at 740 Concourse Pkwy S Ste 200 , Maitland FL 32751-8101. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Sorenson, Demittre Andre Anthony can be contacted via phone (407) 644-4014.

Contact Information

Primary practice address
740 Concourse Pkwy S Ste 200 Maitland FL 32751-8101
Fax:
Website:

Profile Details

NPI number 1881264455
LBN Legal business name Sorenson, Demittre Andre Anthony
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2021
Last updated Sep 6th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881264455 NPPES
Florida MEDICAID 111483000

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