Healthcare Provider Details

I. General information

NPI: 1740201748
Provider Name (Legal Business Name): SEBRING PEDIATRICS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 LAKEVIEW DR
SEBRING FL
33870-7957
US

IV. Provider business mailing address

1550 LAKEVIEW DR
SEBRING FL
33870-7957
US

V. Phone/Fax

Practice location:
  • Phone: 863-382-0770
  • Fax: 863-471-9968
Mailing address:
  • Phone: 863-382-0770
  • Fax: 863-471-9968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. RAJESWARI SONNI
Title or Position: PRESIDENT MEDICAL DIRECTOR
Credential: M.D.
Phone: 863-382-0770