Individual
DR. XIAOSONG SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1846 HIGHWAY 1, ROCKLEDGE, FL 32955-2822
(321) 434-9564
(321) 434-9269
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-9564
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME132088
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021639200
—
FL
01
—
JA823Z
MEDICARE
FL
Enumeration date
06/02/2009
Last updated
12/05/2024
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