Organization
SOURIAL MORRIS SOURIAL MD
Active
Other names
Sourial FP and Pain Care, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOURIAL MORRIS SOURIAL D.O. (PRESIDENT)
(352) 347-1608
Entity
Organization
Contact information
Practice address
16670 S US HIGHWAY 441, SUITE 103, SUMMERFIELD, FL 34491-8683
(352) 347-1608
(888) 241-3383
Mailing address
16670 S US HIGHWAY 441, SUITE 103, SUMMERFIELD, FL 34491-8683
(352) 347-1608
(888) 241-3383
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
OS11425
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000229116
—
FL
01
—
14H1P
BLUE CROSS AND BLUE SHIELD FLORIDA
FL
01
—
151441
HUMANA
FL
Enumeration date
09/17/2014
Last updated
02/09/2015
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