Provider Demographics
NPI:1568466159
Name:SEALS, ALBERT A (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:A
Last Name:SEALS
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 1:1658 ST VINCENTS WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-8431
Mailing Address - Country:US
Mailing Address - Phone:904-276-5100
Mailing Address - Fax:904-276-5393
Practice Address - Street 1:1658 ST VINCENTS WAY STE 300
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-8431
Practice Address - Country:US
Practice Address - Phone:904-276-5100
Practice Address - Fax:904-276-5393
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 49148207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73312OtherBCBS
FL060013146OtherRAILROAD MEDICARE
FL049903000Medicaid
FL73312ZMedicare PIN
FL049903000Medicaid
FL73312VMedicare PIN
FL73312WMedicare PIN