Provider Demographics
NPI:1699938472
Name:SOSA, EDGAR (DO)
Entity type:Individual
Prefix:
First Name:EDGAR
Middle Name:
Last Name:SOSA
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5070 HIGHWAY A1A STE A
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-1229
Mailing Address - Country:US
Mailing Address - Phone:772-234-3700
Mailing Address - Fax:772-234-3770
Practice Address - Street 1:5070 HIGHWAY A1A STE A
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-1229
Practice Address - Country:US
Practice Address - Phone:772-234-3700
Practice Address - Fax:772-234-3770
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS-14580208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty