Provider Demographics
NPI:1083319156
Name:SYKES, GEORGIA MAY
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:MAY
Last Name:SYKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 NELSON TILLIS BLVD UNIT 203
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-2234
Mailing Address - Country:US
Mailing Address - Phone:239-202-7600
Mailing Address - Fax:
Practice Address - Street 1:12557 NEW BRITTANY BLVD STE 3
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3651
Practice Address - Country:US
Practice Address - Phone:877-239-6558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty