Provider Demographics
NPI:1528269917
Name:SORIANO, ANDRES O (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:O
Last Name:SORIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-9950
Practice Address - Street 1:836 SUNSET LAKE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7554
Practice Address - Country:US
Practice Address - Phone:941-408-0500
Practice Address - Fax:941-496-8558
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1362207RH0003X
FLME118024207RX0202X, 207RH0000X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010044600Medicaid
TXP00449363OtherMEDICARE RAILROAD
TX8AN360OtherBLUE CROSS BLUE SHIELD
FL010044600Medicaid
TX8AN360OtherBLUE CROSS BLUE SHIELD
TXP00449363OtherMEDICARE RAILROAD