Provider Demographics
NPI:1902435522
Name:BROCK-HAWKINS, SONYA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:BROCK-HAWKINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:700 S HARBOUR ISLAND BLVD UNIT 106
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5719
Mailing Address - Country:US
Mailing Address - Phone:314-210-4492
Mailing Address - Fax:
Practice Address - Street 1:700 S HARBOUR ISLAND BLVD UNIT 106
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5719
Practice Address - Country:US
Practice Address - Phone:314-210-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist