Healthcare Provider Details

I. General information

NPI: 1124562707
Provider Name (Legal Business Name): GRACE SOZIO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRACE AKDIKMEN RN

II. Dates (important events)

Enumeration Date: 12/15/2016
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11689 BALD EAGLE WAY
NAPLES FL
34120-4320
US

IV. Provider business mailing address

11689 BALD EAGLE WAY
NAPLES FL
34120-4320
US

V. Phone/Fax

Practice location:
  • Phone: 914-815-7117
  • Fax: 914-815-7117
Mailing address:
  • Phone: 914-815-7117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0121X
TaxonomyPlastic Surgery Registered Nurse
License Number675622-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: