Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sophia Diane Bellavista, LAT, ATC

Individual provider Athletic Trainer · NPI 1760973572

Sophia Diane Bellavista, LAT, ATC is an Athletic Trainer in Ponte Vedra Beach, Florida. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

100 Executive Way Ste 109
Ponte Vedra Beach, FL 32082-2713
Phone: (904) 543-9011
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X

Record details

NPI number1760973572
Entity typeIndividual (Type 1)
GenderFemale
Credentials LAT , ATC
Sole proprietorNo
NPI enumeratedMay 29, 2018
Last updated in NPPESMay 29, 2018

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