1710905575 NPI number — FLOYD E SESKIN MD PA

Table of content: (NPI 1710905575)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710905575 NPI number — FLOYD E SESKIN MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLOYD E SESKIN MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710905575
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1921 NE 188TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
N MIAMI BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33179-4350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-792-6905
Provider Business Mailing Address Fax Number:
305-792-6908

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21097 NE 27TH CT
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
AVENTURA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33180-1204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-792-6905
Provider Business Practice Location Address Fax Number:
305-792-6908
Provider Enumeration Date:
07/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SESKIN
Authorized Official First Name:
FLOYD
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRES
Authorized Official Telephone Number:
305-792-6905

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  ME60152 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2282067 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 059603500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12286 . This is a "FL BC/BS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 627342 . This is a "ANTHEM" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 721210004 . This is a "CIGNA PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 001631 . This is a "NHP PROVIDER NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 6002111 . This is a "GHI PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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