Sicknwell LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SICKNWELL LLC

Practice address

1990 N Prospect Ave
Lecanto, FL 34461-9792

Phone

(352) 527-6888

Fax

(352) 527-8818

NPI assigned

Aug 16, 2018

Organization subpart

No

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

Authorized official

Name

Dacelin St Martin, MD

Title

Medical Director / Owner

Phone

(352) 527-6888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1871073122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2066",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344602066",
            "telephone_number": "352-563-0931",
            "fax_number": "352-563-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 N PROSPECT AVE",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344619792",
            "telephone_number": "352-527-6888",
            "fax_number": "352-527-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SICKNWELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "ST MARTIN",
        "authorized_official_first_name": "DACELIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / OWNER",
        "authorized_official_telephone_number": "352-527-6888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucille Theresa Seijas, C.N.M.
• Sandra Marie Setien-Lopez, COTA
• Lilia Rashitovna Shammas, M.D.
• Lesa Lynn Shelton, M.S.
• Jeannette Short, LCSW
• Michael Philip Silverstein, MD
• Jason Sirel, APRN
• Stephen James Smenkowski, PA-C
• Carol Ann Smith, OTA/L
• Hayley Redrick Smith, MD

• Multi-Specialty Clinic/Center in Lecanto, FL
• Providers in Lecanto, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.