Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 229855 | MA |
N | 208000000X | Pediatrician | ME104427 | FL |
Y | 2080P0214X | Pediatric Pulmonologist | ME104427 | FL |
NPI | 1336212588 |
---|---|
Provider Name | Maggie R Sifain |
First Address | Jacksonville, FL 32247-5720 |
Second Address | Orlando, FL 32806-2946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 11/11/2011 |