MEDICARE: MS. SOPHIA DANIELLE RAZIS APRN

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	363LP0200X	Pediatric Nurse Practitioner	APRN11001404	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548721830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SOPHIA DANIELLE RAZIS APRN

Provider Business Mailing Address
First Line	:	1371 CITRUS TOWER BLVD
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1909
Country	:	US
Telephone Number	:	352-708-4828
Fax Number	:

Provider Business Practice Location Address
First Line	:	1371 CITRUS TOWER BLVD
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1909
Country	:	US
Telephone Number	:	352-708-4828
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2019
Last Update Date	:	06/22/2026

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