MEDICARE: CARMEN ANA SIERRA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME117196	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811949415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN ANA SIERRA M.D.

Provider Business Mailing Address
First Line	:	7459 GATHERING LOOP
Second Line	:
City	:	REUNION
State	:	FL
Zip	:	34747-3128
Country	:	US
Telephone Number	:	773-425-3525
Fax Number	:

Provider Business Practice Location Address
First Line	:	4741 OLD CANOE CREEK RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34769-1400
Country	:	US
Telephone Number	:	321-805-4787
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	05/11/2015

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