Provider Demographics
NPI:1689631418
Name:SCHOEPPEL, SONJA L (MD)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:L
Last Name:SCHOEPPEL
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 1:7015 A C SKINNER PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6932
Mailing Address - Country:US
Mailing Address - Phone:904-363-2113
Mailing Address - Fax:904-345-5841
Practice Address - Street 1:7015 A C SKINNER PKWY BLDG 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6932
Practice Address - Country:US
Practice Address - Phone:904-516-3737
Practice Address - Fax:904-516-3738
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME611422085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14352OtherBCBS
FLP00198070OtherRAILROAD MEDICARE
FL100895OtherAVMED
FLCS266BOtherMEDICARE
FL022825600Medicaid
GA339951586AMedicaid
FLB18142Medicare UPIN
GA339951586AMedicaid
FL057987400Medicaid
FL14352UMedicare PIN
FL14352TMedicare PIN
FL14352KMedicare PIN
FL14352OtherBCBS
FL14352JMedicare PIN
FL14352GMedicare PIN
FL14352NMedicare PIN