Sirbiladze, Rowella Licup
Sirbiladze, Rowella Licup is an sole proprietor health care provider with primary practice located at 8960 Colonial Center Dr Ste 202 , Fort Myers FL 33905-7810. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Sirbiladze, Rowella Licup can be contacted via phone (239) 343-9646.Contact Information
Primary practice address
8960 Colonial Center Dr Ste 202
Fort Myers FL 33905-7810
Phone: (239) 343-9646
Fax: (239) 343-9681
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | ME151358 | Florida |
Profile Details
| NPI number | 1194907279 |
|---|---|
| LBN Legal business name | Sirbiladze, Rowella Licup |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 30th, 2007 |
| Last updated | Jul 15th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194907279 | NPPES |
| Florida | MEDICAID | 114292600 |
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