1164707576 NPI number — MS. ELIZABETH SOMMER ARNP

Table of content: MS. ELIZABETH SOMMER ARNP (NPI 1164707576)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164707576 NPI number — MS. ELIZABETH SOMMER ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOMMER
Provider First Name:
ELIZABETH
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164707576
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12008 S SHORE BLVD
Provider Second Line Business Mailing Address:
STE 108
Provider Business Mailing Address City Name:
WELLINGTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33414-6395
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-293-4305
Provider Business Mailing Address Fax Number:
561-828-3111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11476 OKEECHOBEE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROYAL PALM BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33411-8715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-204-5111
Provider Business Practice Location Address Fax Number:
561-204-5150
Provider Enumeration Date:
10/17/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  ARNP9190576 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP2300X , with the licence number: ARNP9190576 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)