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Organization

SOMA MEDICAL CENTER, P. A #4

Active
Parent organization
SOMA MEDICAL CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOMA MEDICAL CENTER
Authorized official
DR. MERCEDES GADEA LOPEZ MD (PEDIATRICIAN)
(561) 275-1155
Entity
Organization

Contact information

Practice address
421 S DIXIE HWY, LAKE WORTH, FL 33460-4442
(561) 275-1155
(561) 275-1156
Mailing address
421 S DIXIE HWY, LAKE WORTH, FL 33460-4442
(561) 275-1155
(561) 275-1156

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME102127
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005584600
FL
Enumeration date
02/01/2011
Last updated
12/11/2019
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