Provider Demographics
NPI:1063484731
Name:SEAMAN, THOMAS WALTER (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:WALTER
Last Name:SEAMAN
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3948 TOWN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837
Mailing Address - Country:US
Mailing Address - Phone:407-856-7000
Mailing Address - Fax:407-856-4647
Practice Address - Street 1:3948 TOWN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837
Practice Address - Country:US
Practice Address - Phone:407-856-7000
Practice Address - Fax:407-856-4647
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2736156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician