Healthcare Provider Details

I. General information

NPI: 1831886001
Provider Name (Legal Business Name): SEAN WORIX PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 TAMPA RD
OLDSMAR FL
34677-6300
US

IV. Provider business mailing address

3705 TAMPA RD
OLDSMAR FL
34677-6300
US

V. Phone/Fax

Practice location:
  • Phone: 813-891-6343
  • Fax: 813-891-6342
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9117388
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: