MEDICARE: SONYA VACHHANI

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	152W00000X	Optometrist	OPC5693	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	:	1659932259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONYA VACHHANI

Provider Business Mailing Address
First Line	:	4600 SUMMERLIN RD STE C4
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3003
Country	:	US
Telephone Number	:	239-936-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 SUMMERLIN RD STE C4
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3003
Country	:	US
Telephone Number	:	239-936-2121
Fax Number	:

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

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	03/16/2026

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Directions to “ SONYA VACHHANI ” Practice Location

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