Sergio B Seoane MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SERGIO B SEOANE MD PA

Practice address

118 Allamanda Sr
Lakeland, FL 33803

Phone

(863) 644-2404

Fax

(863) 904-2510

NPI assigned

Jan 6, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sergio B Seoane, M.D.NPI 1164560702

Title

President

Phone

(863) 644-2204

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Florida Pulmonary Critical Care Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sergio B. Seoane, M.D.,P.a.

  • Family Medicine Physician
  • Lakeland, FL
  • NPI 1417105693
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sergio B. Seoane, M.D.

  • Family Medicine Physician
  • Lakeland, FL
  • NPI 1164560702
  Medicare reassignment NPD Authorized official
• Emma Louise McMicken, ARNP

  • Family Nurse Practitioner
  • Lakeland, FL
  • NPI 1992053144
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1891099792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2186",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338312186",
            "telephone_number": "863-644-2204",
            "fax_number": "863-904-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 ALLAMANDA SR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33803",
            "telephone_number": "863-644-2404",
            "fax_number": "863-904-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGIO B SEOANE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-06",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "SEOANE",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-644-2204",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Marie Sennello, DDS
• Debra L. Seoane, M.D.
• Sergio B. Seoane, M.D.
• Solmaris Sepulveda Rodriguez, PTA
• Serenity Wellness Services Enterprise LLC
• Sergio B. Seoane, M.D.,P.a.
• Sergio H. Vallejo M. D. , P. a.
• Karen Serna, ARNP
• Donald I Serot, MD
• Danelis Yelie Serrano Muniz, COTA/L

• Family Medicine Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.