MEDICARE: SIDNEY STAFFIERE

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	163W00000X	Registered Nurse	9629672	FL

General Provider Information

NPI Number	:	1518750231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIDNEY STAFFIERE

Provider Business Mailing Address
First Line	:	9796 STRIKE LN
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34135-8855
Country	:	US
Telephone Number	:	910-939-9214
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 FGCU BLVD S
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33965-0001
Country	:	US
Telephone Number	:	239-590-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2025
Last Update Date	:	05/26/2025

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Directions to “ SIDNEY STAFFIERE ” Practice Location

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