Provider Demographics
NPI:1538101522
Name:MCFADDEN, SEAN MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MICHAEL
Last Name:MCFADDEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3451 TECHNOLOGICAL AVE STE 15
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-8353
Mailing Address - Country:US
Mailing Address - Phone:407-380-8705
Mailing Address - Fax:407-643-2804
Practice Address - Street 1:3451 TECHNOLOGICAL AVE STE 15
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-8353
Practice Address - Country:US
Practice Address - Phone:407-380-8705
Practice Address - Fax:407-643-2804
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8094207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7461358OtherAETNA PPO
FL264384700Medicaid
FL3717683OtherAETNA HMO
FL12485OtherFHHS PROVIDER NUMBER
FL280549OtherAVMED PROVIDER NUMBER
FL0109468OtherUHC PROVIDER NUMBER
FL58858OtherBLUE CROSS BLUE SHIELD
FL9671701004OtherCIGNA PROVIDER NUMBER
FL280549OtherAVMED PROVIDER NUMBER
FL3717683OtherAETNA HMO
FLE5111WMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER