Provider Demographics
NPI:1336674118
Name:SIKORA INTEGRATIVE MEDICINE PA
Entity Type:Organization
Organization Name:SIKORA INTEGRATIVE MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALITA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SIKORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-410-4945
Mailing Address - Street 1:1255 37TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6550
Mailing Address - Country:US
Mailing Address - Phone:772-228-6882
Mailing Address - Fax:772-228-6883
Practice Address - Street 1:1255 37TH ST STE B
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6550
Practice Address - Country:US
Practice Address - Phone:772-228-6882
Practice Address - Fax:772-228-6883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99541208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05637OtherBCBS
FL280563400Medicaid
FLAG609ZMedicare PIN
FL05637OtherBCBS