Provider Demographics
NPI:1992072490
Name:WOZAB, SOPHIE AC (LMT)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:AC
Last Name:WOZAB
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6260 SW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3481
Mailing Address - Country:US
Mailing Address - Phone:954-554-9103
Mailing Address - Fax:
Practice Address - Street 1:6260 SW 3RD ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3481
Practice Address - Country:US
Practice Address - Phone:954-554-9103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA64014173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist