Basic Information
| Provider Information | |||||||||
| NPI: | 1053882936 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIKRA | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | SIKRA | ||||||||
| OtherFirstName: | KIT | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 9328 CERULEAN DR APT 202 | ||||||||
| Address2: | |||||||||
| City: | RIVERVIEW | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335784775 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134100821 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9225 BAY PLAZA BLVD STE 401 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336194412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134404933 | ||||||||
| FaxNumber: | 8134404916 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2018 | ||||||||
| LastUpdateDate: | 12/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | Y |
No ID Information.