Healthcare Provider Details

I. General information

NPI: 1477631786
Provider Name (Legal Business Name): RICHARD SEDA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 10/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 ALTON RD
MIAMI BEACH FL
33139-3811
US

IV. Provider business mailing address

8200 NW 27 ST STE 108
DORAL FL
33122-1906
US

V. Phone/Fax

Practice location:
  • Phone: 305-538-2226
  • Fax: 305-538-2194
Mailing address:
  • Phone: 786-662-3893
  • Fax: 786-662-3899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO0002447
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: