Healthcare Provider Details

I. General information

NPI: 1669445912
Provider Name (Legal Business Name): MYRTA N SIFONTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MYRTA N SIFONTE RODRIGUEZ MD

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
APO AE GERMANY
09180
DE

IV. Provider business mailing address

UNIT 33100 BOX LANDSTUHL
APO AE
09180-3100
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-6311
  • Fax:
Mailing address:
  • Phone: 314-590-6311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number13426
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number13426
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: