Healthcare Provider Details

I. General information

NPI: 1497085328
Provider Name (Legal Business Name): WILLIAM JOHN SIFLING PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2009
Last Update Date: 04/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 2ND AVE SE SLIP 31
ST PETERSBURG FL
33701-3938
US

IV. Provider business mailing address

300 2ND AVE SE SLIP 31
ST PETERSBURG FL
33701-3938
US

V. Phone/Fax

Practice location:
  • Phone: 727-479-5747
  • Fax: 855-232-8604
Mailing address:
  • Phone: 727-479-5747
  • Fax: 855-232-8604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number27701
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: