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Mr. Demittre Andre Anthony Sorenson, PA-C
Medical Physician Assistant in Maitland, Florida
NPI 1881264455

Demittre Andre Anthony Sorenson is a Medical Physician Assistant based in Fort Myers, FL and is specialized in Medical. Demittre Andre Anthony Sorenson practices in Maitland, FL and has the professional credentials of PA-C. The NPI Number for Demittre Andre Anthony Sorenson is 1881264455 and holds a License No. (Florida).

The current practice location address for Demittre Andre Anthony Sorenson is 740 Concourse Pkwy S Ste 200, Maitland, FL and can be reached out via phone at 407-644-4014.

Location: 740 Concourse Pkwy S Ste 200, Maitland, FL, 33916-2216
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1881264455
Provider Name
Demittre Andre Anthony Sorenson
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
740 Concourse Pkwy S Ste 200, Maitland, FL, 33916-2216
Phone Number
407-644-4014
Fax Number
Provider Enumeration Date
06/28/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
111483000 05 FL
institution
Provider Business Practice Location Address Details
Address
740 Concourse Pkwy S Ste 200
City
Maitland
State
Florida
Zip
32751-8101
Phone Number
407-644-4014
Fax Number
person
Provider Business Mailing Address Details
Address
740 Concourse Pkwy S Ste 200
City
Maitland
State
Florida
Zip
32751-8101
Phone Number
407-644-4014
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA9114808 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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