Individual
DR. PAUL DAVID SOVRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 EAST RUBY AVE, KISSIMME, FL 34741-5679
(407) 847-3333
(407) 847-8622
Mailing address
211 EAST RUBY AVE, KISSIMME, FL 34741-5679
(407) 847-3333
(407) 847-8622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME039107
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME039107
FL
2083A0100X
Aerospace Medicine Physician
ME039107
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47471
BCBS
FL
Enumeration date
06/16/2005
Last updated
05/27/2011
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