Provider Demographics
NPI:1699067264
Name:SOBE WELLNESS INC
Entity type:Organization
Organization Name:SOBE WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIRK
Authorized Official - Middle Name:F
Authorized Official - Last Name:PARVUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-564-7887
Mailing Address - Street 1:PO BOX 6009
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32961-6009
Mailing Address - Country:US
Mailing Address - Phone:772-564-7887
Mailing Address - Fax:772-564-7007
Practice Address - Street 1:1485 37TH ST
Practice Address - Street 2:SUITE 111
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6500
Practice Address - Country:US
Practice Address - Phone:772-564-7887
Practice Address - Fax:772-564-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066484207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty