Bellavista, Sophia Diane

Bellavista, Sophia Diane is an individual health care provider with primary practice located at 100 Executive Way Ste 109 , Ponte Vedra Beach FL 32082-2713. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Bellavista, Sophia Diane can be contacted via phone (904) 543-9011.

Contact Information

Primary practice address
100 Executive Way Ste 109 Ponte Vedra Beach FL 32082-2713
Phone: (904) 543-9011
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X

Profile Details

NPI number 1760973572
LBN Legal business name Bellavista, Sophia Diane
Credentials LAT, ATC
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2018
Last updated May 29th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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