Healthcare Provider Details

I. General information

NPI: 1972315182
Provider Name (Legal Business Name): STEPHANIE SOFIA FERRER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 NW 107TH AVE FL 3
DORAL FL
33178-4377
US

IV. Provider business mailing address

1919 MARKET ST UNIT 1601
PHILADELPHIA PA
19103-1943
US

V. Phone/Fax

Practice location:
  • Phone: 786-624-3368
  • Fax:
Mailing address:
  • Phone: 561-459-6747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: