MEDICARE: CHRISTINE SIERRA RDMS

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	2471S1302X	Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1992482673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE SIERRA RDMS

Provider Business Mailing Address
First Line	:	77 BELINDA CT
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32092-0094
Country	:	US
Telephone Number	:	904-234-4898
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 DURBIN STATION CT STE 303
Second Line	:
City	:	ST JOHNS
State	:	FL
Zip	:	32259-9368
Country	:	US
Telephone Number	:	904-417-8006
Fax Number	:

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

Provider Enumeration Date	:	07/03/2023
Last Update Date	:	07/03/2023

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