Provider Demographics
NPI:1649967720
Name:SEYMORE, FEONA
Entity type:Individual
Prefix:
First Name:FEONA
Middle Name:
Last Name:SEYMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N UNIVERSITY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3618
Mailing Address - Country:US
Mailing Address - Phone:954-505-3408
Mailing Address - Fax:954-281-5066
Practice Address - Street 1:1900 N UNIVERSITY DR STE 104
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3618
Practice Address - Country:US
Practice Address - Phone:954-505-3408
Practice Address - Fax:954-281-5066
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical