DR. MICHAEL MAXINO SOBERANO MD NPI 1477596377

NPI Information

  • NPI: 1477596377
  • Provider Name: DR. MICHAEL MAXINO SOBERANO, MD
  • Classification: Pediatrics - 208000000X
  • Entity Type: Individual
  • Address: 493 PROSPERITY LAKE DR
    ST AUGUSTINE, FL
    ZIP 32092
  • Phone: (904) 824-5437

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NPI Details

DR. Michael Maxino Soberano, MD is a pediatrics in St Augustine, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Michael Maxino Soberano, MD NPI is 1477596377. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

493 PROSPERITY LAKE DR
ST AUGUSTINE, FL
ZIP 32092-045
Phone: (904) 824-5437
Fax: (904) 824-7575

The enumeration date for this NPI number is 6/14/2006 and was last updated on 7/9/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsME78696FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1257545101MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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