Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 2736 | FL |
NPI | 1063484731 |
---|---|
Provider Name | Mr. Thomas Walter Seaman |
First Address | Orlando, FL 32837 |
Second Address | Orlando, FL 32837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 08/07/2007 |