Provider Demographics
NPI:1699160424
Name:FERGUSON, SOPHIA M (ARNP)
Entity type:Individual
Prefix:MS
First Name:SOPHIA
Middle Name:M
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:SOPHIA
Other - Middle Name:MARGUERITA
Other - Last Name:FERGUSON SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 639295 DEPT 93303
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9295
Mailing Address - Country:US
Mailing Address - Phone:248-434-6169
Mailing Address - Fax:855-618-6655
Practice Address - Street 1:1776 N PINE ISLAND RD STE 106
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5200
Practice Address - Country:US
Practice Address - Phone:954-376-3739
Practice Address - Fax:844-407-9213
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3136792363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care