Provider Demographics
NPI:1528341500
Name:COLLINS, SONYA JOHNSON (RPH)
Entity type:Individual
Prefix:MS
First Name:SONYA
Middle Name:JOHNSON
Last Name:COLLINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8217 DUNHAM STATION DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3322
Mailing Address - Country:US
Mailing Address - Phone:813-973-8583
Mailing Address - Fax:
Practice Address - Street 1:20741 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2913
Practice Address - Country:US
Practice Address - Phone:813-907-0878
Practice Address - Fax:813-907-8480
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0028594183500000X
LA15722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist