Provider Demographics
NPI:1245349018
Name:SEIBEL, MATTHEW A (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:SEIBEL
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 1:92 W MILLER ST
Mailing Address - Street 2:MAIL POINT 356
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2032
Mailing Address - Country:US
Mailing Address - Phone:407-839-2048
Mailing Address - Fax:407-649-6986
Practice Address - Street 1:92 W MILLER ST
Practice Address - Street 2:MAIL POINT 356
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2032
Practice Address - Country:US
Practice Address - Phone:407-839-2048
Practice Address - Fax:407-649-6986
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0044090208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045251300Medicaid
FL045251300Medicaid
47725ZMedicare ID - Type Unspecified