Individual
SUFIAN JABBAR SORATHIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3635 CLYDE MORRIS BLVD STE 100, PORT ORANGE, FL 32129-2349
(386) 788-1242
(386) 756-8802
Mailing address
4800 BELFORT RD, JACKSONVILLE, FL 32256-6004
(904) 398-7205
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME130655
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108374600
—
FL
Enumeration date
02/12/2014
Last updated
01/05/2021
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