Provider Demographics
NPI:1578946075
Name:INTRIAGO, SOFIA (ARNP)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:INTRIAGO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21097 NE 27TH CT
Mailing Address - Street 2:SUITE 580
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1204
Mailing Address - Country:US
Mailing Address - Phone:305-935-5101
Mailing Address - Fax:305-935-5107
Practice Address - Street 1:21097 NE 27TH CT
Practice Address - Street 2:SUITE 580
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1204
Practice Address - Country:US
Practice Address - Phone:305-935-5101
Practice Address - Fax:305-935-5107
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9284622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily