Provider Demographics
NPI:1417105693
Name:SERGIO B. SEOANE, M.D.,P.A.
Entity Type:Organization
Organization Name:SERGIO B. SEOANE, M.D.,P.A.
Other - Org Name:FLORIDA PULMONARY & CRITICAL CARE ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:B
Authorized Official - Last Name:SEOANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-644-2204
Mailing Address - Street 1:PO BOX 2186
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33831-2186
Mailing Address - Country:US
Mailing Address - Phone:863-644-2204
Mailing Address - Fax:
Practice Address - Street 1:118 ALLAMANDA DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2926
Practice Address - Country:US
Practice Address - Phone:863-644-2204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-30
Last Update Date:2008-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty