Individual
SONIA BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
131 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34984-5042
(772) 807-1580
Mailing address
870 NEW HAMPTON WAY, MERRITT ISLAND, FL 32953-3223
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9367268
FL
363L00000X
Nurse Practitioner
11029150
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
11029150
FL
Other
Enumeration date
04/16/2022
Last updated
05/07/2024
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