Individual
FLORA CONSUL SAKORNSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3000
Mailing address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3064
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME33689
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037877100
—
FL
Enumeration date
07/07/2006
Last updated
11/15/2011
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