Individual provider · Type 1 NPI

Rustin G. Sorensen, PA-C

Surgical Physician Assistant · Niceville, FL

NPI number 1164433827 Active

Practice location

1950 Bluewater Blvd, Suite 100
Niceville, FL 32578

Fax (850) 897-3846

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA9101453 (FL)

Surgical Physician Assistant: Definition to come...

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About NPI 1164433827

Rustin G. Sorensen, PA-C's National Provider Identifier is 1164433827, issued on Aug 10, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Niceville, FL. The record was last updated on Jan 27, 2010.