Individual
MS. SOFIA WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8515 S US HIGHWAY 1 STE 3, PORT ST LUCIE, FL 34952-3346
(772) 380-4042
Mailing address
1050 SE MONTEREY RD STE 101, STUART, FL 34994-4512
(772) 678-7043
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9107517
FL
Other
Enumeration date
11/06/2013
Last updated
03/28/2019
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