Provider Demographics
NPI:1942859087
Name:BOBES, SOPHIA NICOLE (MSED)
Entity Type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:NICOLE
Last Name:BOBES
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 NW 15TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1431
Mailing Address - Country:US
Mailing Address - Phone:305-325-1818
Mailing Address - Fax:
Practice Address - Street 1:750 NW 15TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1431
Practice Address - Country:US
Practice Address - Phone:305-325-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologist