Wilder, Sean M

Wilder, Sean M is an individual health care provider with primary practice located at 1919 W Swann Ave Fl 2 , Tampa FL 33606-2417. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is his primary health care specialty. Wilder, Sean M can be contacted via phone (813) 254-7079.

Contact Information

Primary practice address
1919 W Swann Ave Fl 2 Tampa FL 33606-2417
Phone: (813) 254-7079
Fax: (813) 443-8164
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 28224842A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X APRN11001912 Florida

Profile Details

NPI number 1275916165
LBN Legal business name Wilder, Sean M
Credentials APRN-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2015
Last updated May 8th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275916165 NPPES
Florida MEDICAID 102642600

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