Sia Medical Center Corp

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SIA MEDICAL CENTER CORP

Practice address

12811 Kenwood LN Ste 105
Fort Myers, FL 33907-5643

Phone

(305) 833-9690

NPI assigned

Jan 23, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Frank E Scull-Justiz

Title

President

Phone

(305) 833-9690

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1669062691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12811 KENWOOD LN STE 105",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075643",
            "telephone_number": "305-833-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12811 KENWOOD LN STE 105",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075643",
            "telephone_number": "305-833-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIA MEDICAL CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-23",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "SCULL-JUSTIZ",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-833-9690"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Maleah Shuck, APRN, CNM
• Lori Mionske Shula, M. A.
• Adam Michael Shuster, DO
• Helene Shute, LCSW
• Scott David Shwedel, DDS
• Mark A Sibley, MD
• Judy Sicilia, PSY D
• Debra Lee Sicilian, APRN
• Asma Siddiqui, MD
• Talha Ali Siddiqui, M.D.

• Physical Therapist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.