Provider Demographics
NPI:1386621019
Name:SIRON, JUDITH A (APRN)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:SIRON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 S. PARSONS AVE
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511
Mailing Address - Country:US
Mailing Address - Phone:813-654-2273
Mailing Address - Fax:813-413-8563
Practice Address - Street 1:401 OAKFIELD DR.
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:813-654-2273
Practice Address - Fax:813-413-8563
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9265982363LX0001X
VA0017136835367A00000X
FLAPRN9265982367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003500800Medicaid
VA7794622Medicaid
FL003500800Medicaid