Individual
SHANE MICHAEL SOORUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, AGACNP-BC
Contact information
Practice address
1400 NW 12TH AVE, MIAMI, FL 33136-1087
(269) 217-3695
Mailing address
118 NW 100TH ST, MIAMI SHORES, FL 33150-1206
(269) 217-3695
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11016761
FL
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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