Provider Demographics
NPI:1598822090
Name:SEEGER, ALLEN RANDALL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:RANDALL
Last Name:SEEGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:451 SW BETHANY DR
Mailing Address - Street 2:STE 201
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-1964
Mailing Address - Country:US
Mailing Address - Phone:772-335-3056
Mailing Address - Fax:772-335-7122
Practice Address - Street 1:451 SW BETHANY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1964
Practice Address - Country:US
Practice Address - Phone:772-335-3056
Practice Address - Fax:772-335-7122
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 53261208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME 53261OtherMEDICAL LICENSE NUMBER
FL49547600Medicaid
FLAS2589286OtherDEA NUMBER
FLAS2589286OtherDEA NUMBER
FLME 53261OtherMEDICAL LICENSE NUMBER
FLAS2589286OtherDEA NUMBER