Provider Demographics
NPI:1992111439
Name:PAIGE, SONYA
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:PAIGE
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:PO BOX 51677
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33994-1677
Mailing Address - Country:US
Mailing Address - Phone:239-822-8981
Mailing Address - Fax:239-288-6990
Practice Address - Street 1:414 BUENA VISTA BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-3654
Practice Address - Country:US
Practice Address - Phone:239-822-8981
Practice Address - Fax:239-288-6990
Is Sole Proprietor?:No
Enumeration Date:2014-07-04
Last Update Date:2014-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator