Provider Demographics
NPI:1740177815
Name:SONGER, KEVIN (QIGONG INSTRUCTOR)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:SONGER
Suffix:
Gender:M
Credentials:QIGONG INSTRUCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4922 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-3768
Mailing Address - Country:US
Mailing Address - Phone:386-283-7161
Mailing Address - Fax:
Practice Address - Street 1:4922 WINCHESTER DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-3768
Practice Address - Country:US
Practice Address - Phone:386-283-7161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty