Individual
DR. ROBERT DAVID SIWICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
914A MAR WALT DR, FORT WALTON BEACH, FL 32547-6606
(850) 862-4119
(850) 862-5470
Mailing address
914A MAR WALT DR, FORT WALTON BEACH, FL 32547-6706
(850) 862-4119
(850) 862-5470
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO1110
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041128100
—
FL
01
—
CN7984
RAILROAD MEDICARE PALMETTO GBA
FL
Enumeration date
12/20/2005
Last updated
09/26/2012
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