Michael Maxino Soberano, MD

Pediatrics Physician · St Augustine, FL

Individual Active NPI

NPI number 1477596377

Practice location

493 Prosperity Lake Dr
St Augustine, FL 32092-5045
Phone
(904) 824-5437
Fax
(904) 824-7575

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NPI record

NPI
1477596377
Entity type
Individual (Type 1)
Enumeration date
June 14, 2006
Last updated
July 9, 2020
Certified
July 9, 2020
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatrics Physician Primary 208000000X ME78696 FL

About Dr. Soberano

Michael Maxino Soberano, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 493 Prosperity Lake Dr, St Augustine, FL 32092-5045. The NPI number 1477596377 was assigned on June 14, 2006 and the record was last updated on July 9, 2020.

Dr. Soberano lists a license in the registry: #ME78696 (FL) for Pediatrics Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Michael Maxino Soberano, MD?

The NPI number is 1477596377.

What is the phone number of Dr. Soberano?

The phone number listed for the practice location is (904) 824-5437.

Where is Dr. Soberano located?

493 Prosperity Lake Dr, St Augustine, FL 32092-5045.

What is the taxonomy code for Dr. Soberano?

The primary taxonomy code is 208000000X – Pediatrics Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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