Provider Demographics
NPI:1902015712
Name:SONPAL, LATA (PH D,FCHT)
Entity Type:Individual
Prefix:DR
First Name:LATA
Middle Name:
Last Name:SONPAL
Suffix:
Gender:F
Credentials:PH D,FCHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9990 SW 77TH AVE STE 218
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2618
Mailing Address - Country:US
Mailing Address - Phone:305-271-2772
Mailing Address - Fax:305-271-2747
Practice Address - Street 1:9990 SW 77TH AVE STE 218
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156
Practice Address - Country:US
Practice Address - Phone:305-271-2772
Practice Address - Fax:305-271-2747
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4437103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist