Provider Demographics
NPI:1962985390
Name:SCIORTINO, SONIA MAGDALENA
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:MAGDALENA
Last Name:SCIORTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 TWIN BRIDGES RD
Mailing Address - Street 2:
Mailing Address - City:SILSBEE
Mailing Address - State:TX
Mailing Address - Zip Code:77656-7113
Mailing Address - Country:US
Mailing Address - Phone:760-490-7940
Mailing Address - Fax:
Practice Address - Street 1:705 HIGHWAY 418 W
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-3635
Practice Address - Country:US
Practice Address - Phone:760-490-7940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2127988225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant