Provider Demographics
NPI:1265611966
Name:BAER, SONJA RENAE (PA-C)
Entity type:Individual
Prefix:MS
First Name:SONJA
Middle Name:RENAE
Last Name:BAER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6000 UNIVERSITY AVE STE 450
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8229
Mailing Address - Country:US
Mailing Address - Phone:515-241-2000
Mailing Address - Fax:515-241-2005
Practice Address - Street 1:6600 UNIVERSITY PKWY STE 302
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9048
Practice Address - Country:US
Practice Address - Phone:941-800-5001
Practice Address - Fax:941-800-5012
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9118914363A00000X
IA001863363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL123747400Medicaid