Individual
DR. SOO Y NAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
701 W COCOA BEACH CSWY, COCOA BEACH, FL 32931
(321) 868-5871
(321) 868-5852
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME101539
FL
208M00000X
Hospitalist Physician
Primary
ME101539
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281280100
—
FL
01
—
AK637T
MEDICARE HF
FL
Enumeration date
01/23/2007
Last updated
10/13/2023
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