Provider Demographics
NPI:1235325804
Name:SEALYM NEUROLOGY & EPILEPSY, PLLC
Entity Type:Organization
Organization Name:SEALYM NEUROLOGY & EPILEPSY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DALWYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SEALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-242-8486
Mailing Address - Street 1:PO BOX 411177
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32941-1177
Mailing Address - Country:US
Mailing Address - Phone:321-242-8486
Mailing Address - Fax:321-242-5979
Practice Address - Street 1:7000 SPYGLASS CT
Practice Address - Street 2:SUITE 350
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8288
Practice Address - Country:US
Practice Address - Phone:321-242-8486
Practice Address - Fax:321-242-5979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME889192084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME88919OtherMEDICAL LICENSE
FLBS4966353OtherDEA
FLK5119Medicare PIN
FLBS4966353OtherDEA