Healthcare Provider Details

I. General information

NPI: 1659756476
Provider Name (Legal Business Name): SEAN HESS D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 LISENBY AVE
PANAMA CITY FL
32405-3730
US

IV. Provider business mailing address

1710 LISENBY AVE
PANAMA CITY FL
32405-3730
US

V. Phone/Fax

Practice location:
  • Phone: 850-807-4420
  • Fax:
Mailing address:
  • Phone: 850-807-4420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberOS13528
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS 13528
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: