Individual
BRUCE SICILIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 S TAMIAMI TRL, SARASOTA, FL 34239-3509
(941) 917-8561
(941) 917-2675
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
MD053377L
PA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME141440
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014865020004
—
PA
01
—
250010983
RAIL ROAD MEDICARE
PA
Enumeration date
01/26/2006
Last updated
01/14/2020
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