Provider Demographics
NPI:1538222195
Name:SIKORA AMENDOLA, JANET MARIE (DC)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:MARIE
Last Name:SIKORA AMENDOLA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 SE WOODBINE RD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-2302
Mailing Address - Country:US
Mailing Address - Phone:321-723-1415
Mailing Address - Fax:
Practice Address - Street 1:790 SE WOODBINE RD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-2302
Practice Address - Country:US
Practice Address - Phone:321-723-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2022-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7112111N00000X, 111NN0400X
NY7937111N00000X, 111NN0400X
SC4051111N00000X, 111NN0400X
FL7112111NN0400X, 111N00000X
NY7939111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380996000Medicaid
FLU63244Medicare UPIN
FL380996000Medicaid