Individual
MICHAEL W SISTARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7031 SW 62ND AVE, SOUTH MIAMI, FL 33143-4701
(305) 284-7761
Mailing address
2442 JACK MCKINNEY RD, RUTHERFORDTON, NC 28139-7788
(954) 249-1158
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS20400
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/27/2018
Last updated
09/15/2023
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