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Individual

ANDREW DAVID SISISKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
621 NW 108TH AVE, PLANTATION, FL 33324-1002
(305) 710-4457
Mailing address
621 NW 108TH AVE, PLANTATION, FL 33324-1002
(305) 710-4457

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
11028
FL

Other

Enumeration date
10/11/2023
Last updated
10/11/2023
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