Provider Demographics
NPI:1063467983
Name:MICHAEL, SONIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11880 SW 40TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3575
Mailing Address - Country:US
Mailing Address - Phone:305-220-0220
Mailing Address - Fax:305-220-0610
Practice Address - Street 1:7306 SW 117TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-3804
Practice Address - Country:US
Practice Address - Phone:305-220-0220
Practice Address - Fax:866-285-7068
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL55115207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0055115OtherMEDICAL LICENSE
FLME0055115OtherMEDICAL LICENSE
FLME0055115OtherMEDICAL LICENSE
FLF40239Medicare UPIN
FL17705WMedicare ID - Type Unspecified