Provider Demographics
NPI:1952434086
Name:HAMMOND, SONYA R (ARNP)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:R
Last Name:HAMMOND
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:R
Other - Last Name:MULLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2450 TAMIAMI TRL STE A
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-3922
Practice Address - Country:US
Practice Address - Phone:941-624-2704
Practice Address - Fax:941-627-6066
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9378929363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200854130Medicaid
IN71002323AOtherNP LICENSE
FL013522400Medicaid
IN000000792122OtherANTHEM
IN71002323AOtherNP LICENSE