Provider Demographics
NPI:1992743421
Name:SORALUZ, OSCAR A (MD)
Entity type:Individual
Prefix:
First Name:OSCAR
Middle Name:A
Last Name:SORALUZ
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 1:2900 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE #221
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5013
Mailing Address - Country:US
Mailing Address - Phone:702-233-9222
Mailing Address - Fax:702-685-4246
Practice Address - Street 1:2900 W HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE #221
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5013
Practice Address - Country:US
Practice Address - Phone:702-233-9222
Practice Address - Fax:702-685-4246
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60130489207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8902009OtherMEDICARE UNSPECIFIED
NVV113355OtherMEDICARE
H65293Medicare UPIN