MEDICARE: SONIC VIBES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471S1302X	Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1053063495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SONIC VIBES

Provider Business Mailing Address
First Line	:	6655 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-1507
Country	:	US
Telephone Number	:	561-707-8212
Fax Number	:

Provider Business Practice Location Address
First Line	:	6655 LAKE WORTH RD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-1507
Country	:	US
Telephone Number	:	561-707-8212
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JENNIFER WOOD
Credential	:
Telephone Number	:	561-332-7646

Provider Enumeration Date	:	01/26/2022
Last Update Date	:	01/26/2022

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Directions to “SONIC VIBES ” Practice Location

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