Individual
VIVIAM SIFONTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ITDS
Contact information
Practice address
4001 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33614-7011
(813) 876-1605
Mailing address
4001 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33614-7011
(813) 876-1605
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
174400000X
Specialist
—
—
174H00000X
Health Educator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811698900
—
FL
Enumeration date
12/27/2006
Last updated
04/21/2017
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