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General NPI Number Information
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NPI Number | 1518085406
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Entity Type | Individual
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Provider Name | MONTE R SICHELMAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 1247 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-4673
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Country | US
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Telephone | 863-688-5604
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Fax | 863-682-6052
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Provider Business Mailing Address
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Address Line | 1247 LAKELAND HILLS BLVD
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City | LAKELAND
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State | FL
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Zip | 33805-4673
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Country | US
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Telephone | 863-688-5604
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Fax | 863-682-6052
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME97405
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License Number State | FL
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