Provider Demographics
NPI:1255621686
Name:SEEHAUSEN, TIM F (MD)
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:F
Last Name:SEEHAUSEN
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 1:12702 WATERBURY LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3103
Mailing Address - Country:US
Mailing Address - Phone:813-961-7269
Mailing Address - Fax:
Practice Address - Street 1:12702 WATERBURY LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-3103
Practice Address - Country:US
Practice Address - Phone:813-961-7269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32506207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine