SONIA RAE REISDORF


Address: 400 Health Park Blvd, St Augustine, FL 32086-5784
Phone: 9048194082

SONIA RAE REISDORF (NPI# 1396117693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396117693
Entity Type Individual
Full Name SONIA RAE REISDORF
Credential ARNP
Practice Address 400 Health Park Blvd
St Augustine
FL 32086-5784
Mailing Address Po Box 860069
St Augustine
FL 32086-0069
Practice Telephone 9048194082
Practice Fax Number 9048195056
Mailing Telephone 9048194082
Mailing Fax Number 9048195056
Enumeration Date 2015-10-26
Last Update Date 2017-03-31
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 9318208 FL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 400 HEALTH PARK BLVD
City ST AUGUSTINE
State FL
Zip Code 32086-5784

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801881818 Emergency Physicians of St. Johns County Emergency Medicine 400 Health Park Blvd, St Augustine, FL 32086-5784 2005-09-15
1245846468 Nicole Marie Zisman Internal Medicine 400 Health Park Blvd, St Augustine, FL 32086-5784 2020-09-22
1700499522 Yolanda Campbell Family Medicine 400 Health Park Blvd, St Augustine, FL 32086-5784 2020-08-31
1952912826 Megan Burke Physician Assistant 400 Health Park Blvd, St Augustine, FL 32086-5790 2020-08-13
1639709173 Keith Latasiewicz Nurse Anesthetist, Certified Registered 400 Health Park Blvd, St Augustine, FL 32086-5784 2020-01-23
1508416991 Ashley Jarriel Gucwa Physician Assistant 400 Health Park Blvd, St Augustine, FL 32086-5784 2019-09-17
1831741925 Jessica Anne Lindamood Dietitian, Registered 400 Health Park Blvd, St Augustine, FL 32086-5790 2019-07-10
1649787326 Spencer Jonathan Garrison Nurse Anesthetist, Certified Registered 400 Health Park Blvd, St Augustine, FL 32086-5784 2018-01-04
1750804662 Gabrielle Du Sablon Physician Assistant 400 Health Park Blvd, St Augustine, FL 32086-5784 2017-07-23
1124540588 Jessica Marie Johnson Physician Assistant 400 Health Park Blvd, St Augustine, FL 32086-5784 2017-07-07
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225670037 Ramonica Flagler Nurse Practitioner 3574 Us-1 South, St. Augustine, FL 32086 2019-10-14
1518522648 Marissa Marie Lynch Physician Assistant 100 Whetstone Pl Ste 102, St Augustine, FL 32086 2019-05-03
1346706991 Castillo Transportation Non-emergency Medical Transport (VAN) 295 North Hidden Tree Dr, Saint Augustine, FL 32086 2019-02-19
1790255842 Michelle Moore In Home Supportive Care 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 2018-12-03
1649740200 Paul James Lietz IIi Physical Therapist One Orthopedic Place, Saint Augustine, FL 32086 2018-11-27
1548764707 Oceanside Endodontics Od St. Augustine Dentist 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 2018-03-22
1023538329 Joseph R Edwards Physical Therapist 968 Espinado Avenue, St Augustine, FL 32086 2017-06-27
1235662032 Jennifer L Csenge Dentist 4327 Us Highway 1 S, St Augustine, FL 32086 2017-04-07
1336683663 Lisa Brice Social Worker 248 Southpark Circle East, Saint Augustine, FL 32086 2016-12-06
1558813303 Bio-medical Applications of Florida, Inc. Clinic/Center 65 Whitehall Drive, Saint Augustine, FL 32086 2016-10-27
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1295215531 Vanessa Rutledge Nurse Practitioner 830 Copperhead Cir, St Augustine, FL 32092-2752 2018-08-16
1801394291 Peter Richard Accorti Nurse Practitioner 3657 Gaines Rd, St Augustine, FL 32084-8503 2018-01-31
1033300280 Allied Medical Professionals Inc Nurse Practitioner 121 Fonseca Dr, St Augustine, FL 32086-8867 2007-08-05
1942412481 Anah Marks Nurse Practitioner 301 Health Park Blvd Ste 219, St Augustine, FL 32086-5795 2007-05-04
1255311528 Judith Lynn Nichols Nurse Practitioner 105 Mariner Way, Ste 203, St Augustine, FL 32086 2006-01-20
1336706779 Shawn Rene Wells Nurse Practitioner 120 Palencia Village Dr Ste 107, St Augustine, FL 32095-8553 2019-05-21
1841759255 Monica Antigua Nurse Practitioner 2460 Old Moultrie Rd Ste 5, St Augustine, FL 32086-4198 2019-03-15
1295216414 Ashley Baldwin Sauls Nurse Practitioner 419 Anastasia Blvd, St Augustine, FL 32080-4508 2018-08-25
1780161851 Christine Moore Nurse Practitioner 300 Health Park Blvd Ste 5010, St Augustine, FL 32086-3705 2018-07-23
1710480900 Christina Ellen Barr Nurse Practitioner 1 Saint Johns Medical Park Dr, St Augustine, FL 32086-5300 2018-03-14
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Competitor

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City ST AUGUSTINE
Zip Code 32086

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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