Provider Demographics
NPI:1811997083
Name:KERR, SONJA (MD)
Entity type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:
Last Name:KERR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7975 WEST MCNAB ROAD
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321
Mailing Address - Country:US
Mailing Address - Phone:954-720-6338
Mailing Address - Fax:954-720-6559
Practice Address - Street 1:4630 N UNIVERSITY DR
Practice Address - Street 2:PMB # 316
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4626
Practice Address - Country:US
Practice Address - Phone:954-720-6338
Practice Address - Fax:954-720-6559
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064083207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF64125Medicare UPIN
FL23152Medicare ID - Type Unspecified