Healthcare Provider Details

I. General information

NPI: 1538891106
Provider Name (Legal Business Name): MRS. SOPHIA V ANTOINE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 SW HOLIDAY ST
ARCADIA FL
34266-4218
US

IV. Provider business mailing address

1440 SW HOLIDAY ST
ARCADIA FL
34266-4218
US

V. Phone/Fax

Practice location:
  • Phone: 786-340-8272
  • Fax:
Mailing address:
  • Phone: 863-993-5989
  • Fax: 863-884-8664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberCRPS.0102212.F
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberCCHW.0100694
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: