Provider Demographics
NPI:1528285285
Name:SODRINHO, ALFREDO DE CASTRO (MASTER DEGREE)
Entity type:Individual
Prefix:MR
First Name:ALFREDO
Middle Name:DE CASTRO
Last Name:SODRINHO
Suffix:
Gender:M
Credentials:MASTER DEGREE
Other - Prefix:MR
Other - First Name:ANTARDHAN
Other - Middle Name:DAS
Other - Last Name:ARAUJO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:TEACHER
Mailing Address - Street 1:14000 NW 154TH AVE
Mailing Address - Street 2:APT 05
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615-8265
Mailing Address - Country:US
Mailing Address - Phone:386-418-1285
Mailing Address - Fax:
Practice Address - Street 1:14000 NW 154TH AVE
Practice Address - Street 2:APT 05
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615-8265
Practice Address - Country:US
Practice Address - Phone:386-418-1285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17W00000X171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC4117OtherLMT-CLAIM FOR COVERED SER