Basic Information
| Provider Information | |||||||||
| NPI: | 1437114410 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SIERRA | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | C/O ANESCO NORTH BROWARD LLC | ||||||||
| Address2: | 3601 W COMMERCIAL BLVD STE 45 | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544855666 | ||||||||
| FaxNumber: | 9544841651 | ||||||||
| Practice Location | |||||||||
| Address1: | C/O IMPERIAL POINT MEDICAL CENTER | ||||||||
| Address2: | 6401 NORTH FEDERAL HIGHWAY | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547768500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | ME28272 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.