Provider Demographics
NPI:1376213835
Name:SYKES, BONITA JUSTINA
Entity Type:Individual
Prefix:
First Name:BONITA
Middle Name:JUSTINA
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 1:4701 ADRIENNE ST
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-1710
Mailing Address - Country:US
Mailing Address - Phone:863-585-6978
Mailing Address - Fax:
Practice Address - Street 1:4701 ADRIENNE ST
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-1710
Practice Address - Country:US
Practice Address - Phone:863-585-6978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator