Provider Demographics
NPI:1104359363
Name:SINGH, SEAN RANJIT (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:RANJIT
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 NW SAINT LUCIE WEST BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-1758
Mailing Address - Country:US
Mailing Address - Phone:772-318-4945
Mailing Address - Fax:772-318-4945
Practice Address - Street 1:1555 NW SAINT LUCIE WEST BLVD STE 101
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1758
Practice Address - Country:US
Practice Address - Phone:772-318-4945
Practice Address - Fax:772-318-4945
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME151329207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology