| Sergio B Seoane Md Pa | |
|
118 Allamanda Sr Lakeland FL 33803 | |
| (863) 644-2404 | |
| (863) 904-2510 |
| Full Name | Sergio B Seoane Md Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 118 Allamanda Sr, Lakeland, Florida |
| Authorized Official Name and Position | Sergio B Seoane (PRESIDENT) |
| Authorized Official Contact | 8636442204 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sergio B Seoane Md Pa Po Box 2186 Bartow FL 33831-2186 Ph: (863) 644-2204 | Sergio B Seoane Md Pa 118 Allamanda Sr Lakeland FL 33803 Ph: (863) 644-2404 |
| NPI Number | 1891099792 |
|---|---|
| Provider Enumeration Date | 01/06/2011 |
| Last Update Date | 01/06/2011 |
| Medicare PECOS PAC ID | 5294924536 |
|---|---|
| Medicare Enrollment ID | O20110118000788 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891099792 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sergio B Seoane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164560702 PECOS PAC ID: 2264402361 Enrollment ID: I20040727001197 |
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