Provider Demographics
NPI:1619007705
Name:MCMAHON, SONYA (ARNP)
Entity type:Individual
Prefix:MS
First Name:SONYA
Middle Name:
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3312 37TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-1908
Mailing Address - Country:US
Mailing Address - Phone:941-755-9663
Mailing Address - Fax:941-756-4873
Practice Address - Street 1:5810 BRECKENRIDGE PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4243
Practice Address - Country:US
Practice Address - Phone:813-635-0595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1372532363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health