Provider Demographics
NPI:1760044010
Name:SERPA, SONIA MARIA
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:MARIA
Last Name:SERPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 PARK DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-3159
Mailing Address - Country:US
Mailing Address - Phone:305-756-6110
Mailing Address - Fax:305-759-1255
Practice Address - Street 1:9111 PARK DR
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-3159
Practice Address - Country:US
Practice Address - Phone:305-756-6110
Practice Address - Fax:305-759-1255
Is Sole Proprietor?:No
Enumeration Date:2019-07-07
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004199363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily