MEDICARE: SIRTAZ SINGH SIBIA D.O.

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	207W00000X	Ophthalmology Physician	OS7844	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	49882	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1679518195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIRTAZ SINGH SIBIA D.O.

Provider Business Mailing Address
First Line	:	11195 S JOG RD STE 1&2
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-1829
Country	:	US
Telephone Number	:	561-752-0075
Fax Number	:	561-536-4200

Provider Business Practice Location Address
First Line	:	11195 S JOG RD
Second Line	:	SUITE 1&2
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-1829
Country	:	US
Telephone Number	:	561-752-0075
Fax Number	:	561-536-4200

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

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	04/20/2026

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