Basic Information
| Provider Information | |||||||||
| NPI: | 1528010089 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MADDALENA | ||||||||
| FirstName: | SONIA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BARBOZ | ||||||||
| OtherFirstName: | SONIA | ||||||||
| OtherMiddleName: | MARIE | ||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 215 PERSHING WAY | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334018035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8639832227 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 500 W SUGARLAND HWY | ||||||||
| Address2: | |||||||||
| City: | CLEWISTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334403021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8639832227 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | ME60037 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.