Provider Demographics
NPI:1518066695
Name:SEBASTIAN, THOMAS JUDE (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JUDE
Last Name:SEBASTIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7421 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2977
Mailing Address - Country:US
Mailing Address - Phone:954-721-9494
Mailing Address - Fax:954-726-9028
Practice Address - Street 1:7421 N UNIVERSITY DR
Practice Address - Street 2:SUITE 212
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2977
Practice Address - Country:US
Practice Address - Phone:954-721-9494
Practice Address - Fax:954-726-9028
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2011-08-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0086109207RI0200X
FLME86109207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH24404Medicare UPIN