Provider Demographics
NPI:1952872061
Name:SEOANES, OLGA LORENA (ARNP)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:LORENA
Last Name:SEOANES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:OLGA
Other - Middle Name:LORENA
Other - Last Name:SEOANES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:851 W SR 436 STE 1039
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3041
Mailing Address - Country:US
Mailing Address - Phone:407-571-9074
Mailing Address - Fax:407-571-9175
Practice Address - Street 1:851 W SR 436 STE 1039
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3041
Practice Address - Country:US
Practice Address - Phone:407-571-9074
Practice Address - Fax:407-571-9175
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000366207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLS520652816040OtherSTATE LICENSE