Healthcare Provider Details

I. General information

NPI: 1184529455
Provider Name (Legal Business Name): SONYA UNDERWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9949 LYNN DR
NORTH ROYALTON OH
44133-1421
US

IV. Provider business mailing address

9949 LYNN DR
NORTH ROYALTON OH
44133-1421
US

V. Phone/Fax

Practice location:
  • Phone: 216-394-3624
  • Fax: 216-954-4225
Mailing address:
  • Phone: 216-394-3624
  • Fax: 216-954-4225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN.147068.MEDS-IV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: