Healthcare Provider Details
I. General information
NPI: 1730585068
Provider Name (Legal Business Name): TAMMY GEBO-SEAMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/13/2014
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 LAKELAND HILLS BLVD
LAKELAND FL
33805-3019
US
IV. Provider business mailing address
6522 EAGLE RIDGE WAY
LAKELAND FL
33813-5683
US
V. Phone/Fax
- Phone: 863-680-7490
- Fax: 863-264-8519
- Phone: 315-439-8753
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | OS14072 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: