Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APN.19059 | SC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | APRN218133 | GA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP 9254322 | FL |
NPI | 1992999759 |
---|---|
Provider Name | Mr. Dino Vincent Soriano SR. |
First Address | Guyton, GA 31312-7134 |
Second Address | Guyton, GA 31312-7134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2007 |
Last Update Date | 03/02/2020 |