1538162664 NPI number — DR. SONYA L LEFEVER MD

Table of content: DR. SONYA L LEFEVER MD (NPI 1538162664)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538162664 NPI number — DR. SONYA L LEFEVER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEFEVER
Provider First Name:
SONYA
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CVERCKO
Provider Other First Name:
SONYA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538162664
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1824 KING ST
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32204-4735
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-388-1820
Provider Business Mailing Address Fax Number:
904-388-1827

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1824 KING ST
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32204-4735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-388-1820
Provider Business Practice Location Address Fax Number:
904-388-1827
Provider Enumeration Date:
05/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  ME90417 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0000X , with the licence number: 045437 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 312678467A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 48964 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7336622 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 294068 . This is a "AVMED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 270073500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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