Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1477596377 Individual Practitioner Male Practitioner

Dr. Michael Maxino Soberano , MD

Pediatrics • St Augustine, FL

Professional Overview & Biography Verified Profile Summary

Dr. Michael Soberano, MD is a registered healthcare professional specializing in Pediatrics in St Augustine, FL. Practice services are available at 493 PROSPERITY LAKE DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

493 Prosperity Lake Dr

St Augustine, FL 320925045

Telephone 9048245437
Fax 9048247575
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in St Augustine, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.2 Yrs
Regional Practice Density
17 Specialists

Practicing in St Augustine, FL (4160 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-07-09
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License FL ME78696

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
257545101 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
NPI 1134226699

Doctor of Osteopathic Medicine (D.O.)

Jennifer Angel , APRN

Nurse Practitioner - Pediatrics

NPI 1255415725

Advanced Practice Registered Nurse

Victoria Miller , PA-C

Physician Assistant

NPI 1316946866

Physician Assistant (Certified)

Cyndie Hatcher

Pediatrics

NPI 1538588785
NPI 1598846339

Doctor of Medicine (M.D.)

Natasha Jno Baptiste

Nurse Practitioner - Family

NPI 1811343791

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 09, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location November 09, 2011

Registered at 493 PROSPERITY LAKE DR, ST AUGUSTINE, FL 320925045 (Tel: 9048245437)

📍
Updated Business Mailing Address November 09, 2011

Registered at 493 PROSPERITY LAKE DR, ST AUGUSTINE, FL 320925045 (Tel: 9048245437)

👤
Provider Name / Credentials Updated November 09, 2011

Recorded as MICHAEL SOBERANO, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 09, 2011

Pediatrics (License #ME78696 in FL)

🟢
Initial NPI Registration & Enumeration June 14, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477596377
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 14, 2006
Last Update: July 09, 2020
Sole Proprietor: No

Mailing Address

493 Prosperity Lake Dr

St Augustine, FL 320925045

Phone: 9048245437

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.