Provider Demographics
NPI:1962740332
Name:SIKLER, MATTHEW JAMES (RPH)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JAMES
Last Name:SIKLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19486 SW 68TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33332-1649
Mailing Address - Country:US
Mailing Address - Phone:954-880-0716
Mailing Address - Fax:954-389-2182
Practice Address - Street 1:294 INDIAN TRCE
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-4509
Practice Address - Country:US
Practice Address - Phone:954-384-4196
Practice Address - Fax:954-389-2182
Is Sole Proprietor?:No
Enumeration Date:2013-01-19
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 27032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist