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Individual

DR. EDWIN MICHAEL C SIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
103 PARK PLACE BLVD, DAVENPORT, FL 33837-6858
(863) 421-1855
(863) 421-2624
Mailing address
103 PARK PLACE BLVD, DAVENPORT, FL 33837-6858
(863) 421-1855
(863) 421-2624

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME92906
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
273638100
FL
01
37251
BCBS
FL
Enumeration date
07/24/2006
Last updated
05/06/2026
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