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NPI Code Detail

MEDICARE: MRS. CYNTHIA A SISULAK PT

MEDICARE: MRS. CYNTHIA A SISULAK PT
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
1225100000XPhysical Therapist30463FL

Other Identifiers

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

General Provider Information

NPI Number : 1194915215
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CYNTHIA A SISULAK PT
Provider Business Mailing Address
First Line : 17532 HILLSIDE DR
Second Line :
City : MONTVERDE
State : FL
Zip : 34756-3184
Country : US
Telephone Number : 262-720-5855
Fax Number :
Provider Business Practice Location Address
First Line : 14055 TOWN LOOP BLVD
Second Line : 300
City : ORLANDO
State : FL
Zip : 32837-6106
Country : US
Telephone Number : 262-720-5855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2007
Last Update Date : 01/25/2017

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