Provider Demographics
NPI:1013978055
Name:SEILER, EARNEST EDWARD III (MD)
Entity Type:Individual
Prefix:DR
First Name:EARNEST
Middle Name:EDWARD
Last Name:SEILER
Suffix:III
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1696 WEST HIBISCUS BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901
Mailing Address - Country:US
Mailing Address - Phone:321-725-0554
Mailing Address - Fax:321-952-0202
Practice Address - Street 1:1696 WEST HIBISCUS BLVD
Practice Address - Street 2:STE A
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901
Practice Address - Country:US
Practice Address - Phone:321-725-0554
Practice Address - Fax:321-952-0202
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME510132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E74300Medicare UPIN
10181Medicare ID - Type Unspecified