Organization
SOORENA SADRI DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOORENA SADRI DPM (OWNER)
(239) 590-8860
Entity
Organization
Contact information
Practice address
4956 ROYAL GULF CIR, FORT MYERS, FL 33966-7006
(239) 590-8860
(949) 577-4813
Mailing address
4956 ROYAL GULF CIR, FORT MYERS, FL 33966-7006
(239) 590-8860
(949) 577-4813
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6506A
BLUE SHIELD
FL
01
—
P01066091
RAILROAD MEDICARE
FL
Enumeration date
05/15/2012
Last updated
05/27/2020
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