Sotomayor, Maria Gavancho

Sotomayor, Maria Gavancho is an individual health care provider with primary practice located at 3622 Madaca Ln , Tampa FL 33618-2057. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Sotomayor, Maria Gavancho can be contacted via phone (813) 513-3643.

Contact Information

Primary practice address
3622 Madaca Ln Tampa FL 33618-2057
Phone: (813) 513-3643
Fax: (813) 605-5465
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME94010 Florida

Profile Details

NPI number 1316912082
LBN Legal business name Sotomayor, Maria Gavancho
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Mar 30th, 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 1316912082 NPPES
Florida MEDICAID 110175900

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