Healthcare Provider Details

I. General information

NPI: 1023654449
Provider Name (Legal Business Name): SEAWA ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 NORTH BELCHER ROAD SUITE 100
CLEARWATER FL
33765
US

IV. Provider business mailing address

12221 TOWNE LAKE DR STE A160
FORT MYERS FL
33913-8185
US

V. Phone/Fax

Practice location:
  • Phone: 239-201-7670
  • Fax:
Mailing address:
  • Phone: 239-201-7670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: SARAH ALLEYNE
Title or Position: CEO
Credential:
Phone: 239-201-7670