Provider Demographics
NPI:1669459236
Name:OKUN, SETH J (DPM)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:J
Last Name:OKUN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:2835 W DE LEON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4168
Mailing Address - Country:US
Mailing Address - Phone:813-254-6592
Mailing Address - Fax:813-254-3634
Practice Address - Street 1:2835 W DE LEON ST
Practice Address - Street 2:SUITE 101
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4168
Practice Address - Country:US
Practice Address - Phone:813-254-6592
Practice Address - Fax:813-254-3634
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPO0001463213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2788077OtherUNITED HEALTHCARE
FL87818OtherBLUE CROSS BLUE SHIELD
FLT55561Medicare UPIN
FL87818OtherBLUE CROSS BLUE SHIELD