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Individual
DR. SOORDAL O PRAKASH
Active
Individual
DR. SOORDAL O PRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME76860
FL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
ME76860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
245078
WELLCARE MCARE
—
05
—
266978100
—
FL
01
—
29060
BCBS
FL
01
—
4106534005
CIGNA
—
01
—
7119242
AETNA
FL
Enumeration date
04/17/2006
Last updated
08/26/2022
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