Healthcare Provider Details

I. General information

NPI: 1922928894
Provider Name (Legal Business Name): SOPHIA SKYE NEWMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FIA QUINN

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 BALMORAL CIR N STE 305
JACKSONVILLE FL
32218-5583
US

IV. Provider business mailing address

97479 PIRATES POINT RD
YULEE FL
32097-1407
US

V. Phone/Fax

Practice location:
  • Phone: 904-909-2120
  • Fax:
Mailing address:
  • Phone: 904-415-9051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA108928
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: