Healthcare Provider Details

I. General information

NPI: 1902715907
Provider Name (Legal Business Name): SIBERA WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8883 SW 223RD LN
CUTLER BAY FL
33190-1315
US

IV. Provider business mailing address

9555 SW 175TH TER # 825
PALMETTO BAY FL
33157-5604
US

V. Phone/Fax

Practice location:
  • Phone: 786-340-8599
  • Fax:
Mailing address:
  • Phone: 786-340-8599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARIE SIBERA
Title or Position: OWNER
Credential: APRN, PMHNP-BC
Phone: 786-340-8599