Provider Demographics
NPI:1558657593
Name:SOJDAK, HILARY (MSN APRN PMHNP)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:SOJDAK
Suffix:
Gender:F
Credentials:MSN APRN PMHNP
Other - Prefix:
Other - First Name:HILARY
Other - Middle Name:ANNE
Other - Last Name:RAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NPP
Mailing Address - Street 1:6804 PORTO FINO CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-7139
Mailing Address - Country:US
Mailing Address - Phone:239-332-4700
Mailing Address - Fax:888-769-5641
Practice Address - Street 1:6804 PORTO FINO CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-7139
Practice Address - Country:US
Practice Address - Phone:239-332-4700
Practice Address - Fax:888-769-5641
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9400160363LP0808X, 363LP0808X
NYF401385363LP0808X
FLARNP9400160363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
13841883OtherCAQH