Provider Demographics
NPI:1588169338
Name:GOODMAN, SONYA CHRISTINA (CERTIFICATION)
Entity type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:CHRISTINA
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:CERTIFICATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6548 SANDLER LAKES DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-1690
Mailing Address - Country:US
Mailing Address - Phone:904-444-7943
Mailing Address - Fax:
Practice Address - Street 1:6548 SANDLER LAKES DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32222-1690
Practice Address - Country:US
Practice Address - Phone:904-672-7454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20291372600000X, 376K00000X, 374U00000X, 376J00000X, 385H00000X
376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20291OtherNURSING AIDE