Provider Demographics
NPI:1326157561
Name:NILSSEN, SIGRID (DC)
Entity Type:Individual
Prefix:DR
First Name:SIGRID
Middle Name:
Last Name:NILSSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1674 MERIDIAN AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-2801
Mailing Address - Country:US
Mailing Address - Phone:305-532-7788
Mailing Address - Fax:305-534-6558
Practice Address - Street 1:1674 MERIDIAN AVE
Practice Address - Street 2:STE 203
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-2801
Practice Address - Country:US
Practice Address - Phone:305-532-7788
Practice Address - Fax:305-534-6558
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6134111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22637Medicare ID - Type Unspecified