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Contact Information

RUSTIN G SORENSEN, PA-C
1950 BLUEWATER BLVD
SUITE 100
NICEVILLE, FL32578
 Phone: 850-897-8081
 Fax: 850-897-3846
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for RUSTIN G SORENSEN · (Male)

NPI # 1164433827
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/10/2006
Last updated 01/27/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PA9101453
  • FL Other 970023871 RRMC
Hospital affiliation(s)
  • SACRED HEART HOSPITAL ON THE EMERALD COAST - (Acute Care)
    7800 US HWY 98 W
    MIRAMAR BEACH, FL 32550
  • TWIN CITIES HOSPITAL - (Acute Care)
    2190 HWY 85 N
    NICEVILLE, FL 32578
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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