Provider Demographics
NPI:1992532931
Name:BARBARA, SOPHIA ALEXA (APRN)
Entity type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:ALEXA
Last Name:BARBARA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 SW 137TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33158-1226
Mailing Address - Country:US
Mailing Address - Phone:305-310-4038
Mailing Address - Fax:
Practice Address - Street 1:7220 SW 137TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33158-1226
Practice Address - Country:US
Practice Address - Phone:305-310-4038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty