Provider Demographics
NPI:1760925176
Name:WOOL, SOFYA
Entity Type:Individual
Prefix:
First Name:SOFYA
Middle Name:
Last Name:WOOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SOFYA
Other - Middle Name:
Other - Last Name:STRATIEVSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3046 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4576
Mailing Address - Country:US
Mailing Address - Phone:847-630-3829
Mailing Address - Fax:
Practice Address - Street 1:3046 ORANGE ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4576
Practice Address - Country:US
Practice Address - Phone:847-630-3829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-02
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.022733225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT122173OtherFLORIDA PHYSICAL THERAPY LICENSE