1235571407 NPI number — DR. NATALIA SOPHIA SIKACZOWSKI DPT

Table of content: DR. NATALIA SOPHIA SIKACZOWSKI DPT (NPI 1235571407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235571407 NPI number — DR. NATALIA SOPHIA SIKACZOWSKI DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIKACZOWSKI
Provider First Name:
NATALIA
Provider Middle Name:
SOPHIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235571407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
28 W FLAGLER ST
Provider Second Line Business Mailing Address:
STE 901
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33130-1894
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-331-2277
Provider Business Mailing Address Fax Number:
305-424-9361

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28 W FLAGLER ST
Provider Second Line Business Practice Location Address:
SUITE 901
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33130-1806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-814-8444
Provider Business Practice Location Address Fax Number:
305-424-9361
Provider Enumeration Date:
07/29/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT28379 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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