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SORENTO MEDICAL CLINIC
NPI 1104098565
Clinic/Center - Rural Health in Sorrento, FL

Active since March 26, 2008CLIA 10D1008862 · Waiver
31450 CHURCH STREET, SORRENTO, FL 32776(352) 735-4044(352) 735-2536 Get Directions Write a Review

NPPES record last updated: July 15, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sorento Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SORENTO MEDICAL CLINIC (NPI 1104098565) is a healthcare organization registered as a rural health in Sorrento, Florida and active in the NPI registry since March 2008. The organization holds a CLIA Waiver certificate valid through January 29, 2027 and lists George R Ikeler, Owner, as its authorized official.

NPPES Registry Identity

NPI1104098565
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameGEORGE R IKELER MD PA
Location Address31450 CHURCH STREETSorrento, FL 32776-9594
Mailing Address31450 Church StreetSorrento, FL 32776-9594 · (352) 735-4044 · Fax (352) 735-2536
Phone(352) 735-4044
Fax(352) 735-2536
Organization SubpartNo
Authorized OfficialGeorge R IkelerOwner · (352) 735-4044
Enumeration DateMarch 26, 2008
Last NPPES UpdateJuly 15, 2008
✔ NPI 1104098565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in FL · ME12314
31450 CHURCH STREET, Sorrento, FL 32776
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Other Names 1

Doing Business AsSorento Medical Clinic

Other Identifiers 1

Medicare OSCAR/certification108955FL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1008862

Sorrento Medical Clinic · Sorrento, FL
Active · expires Jan 29, 2027
CLIA Number10D1008862
Laboratory TypePhysician Office
Certificate Effective DateJanuary 30, 2025
Certificate Expiration DateJanuary 29, 2027
Laboratory DirectorGeorge Ikeler MD
Laboratory Phone(352) 735-4033
Laboratory LocationSorrento Medical Clinic31450 Church St, Sorrento, FL 32776
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is George R Ikeler MD PA's NPI number?

The NPI number for George R Ikeler MD PA is 1104098565. It was assigned to this organization in the NPPES registry on March 26, 2008. The provider is doing business as Sorento Medical Clinic.

Where is George R Ikeler MD PA located?

George R Ikeler MD PA is located at 31450 Church Street, Sorrento, FL 32776. The listed phone number is (352) 735-4044.

What is George R Ikeler MD PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does George R Ikeler MD PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1008862) is associated with this NPI, valid through January 29, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for George R Ikeler MD PA was last updated on July 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.