Provider Demographics
NPI:1164920633
Name:ARIAS, SOPHIA M (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:M
Last Name:ARIAS
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20150 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2482
Mailing Address - Country:US
Mailing Address - Phone:813-631-4710
Mailing Address - Fax:
Practice Address - Street 1:20150 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2482
Practice Address - Country:US
Practice Address - Phone:813-631-4710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
COSLP.0006050235Z00000X
TX122923235Z00000X
CA37750235Z00000X
FLSA21631235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37750OtherCALIFORNIA SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY AND HEARING AID DISPENSERS BO
FLSA21631OtherFLORIDA DEPARTMENT OF HEALTH
CO9000233167Medicaid
COSLP.0006050OtherCOLORADO DIVISION OF PROFESSIONS AND OCCUPATIONS
TX122923OtherTEXAS DEPARTMENT OF LICENSING AND REGULATION