Healthcare Provider Details

I. General information

NPI: 1710710504
Provider Name (Legal Business Name): SEAN MURPHY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2418 SE FEDERAL HWY
STUART FL
34994-4531
US

IV. Provider business mailing address

2418 SE FEDERAL HWY
STUART FL
34994-4531
US

V. Phone/Fax

Practice location:
  • Phone: 772-286-7326
  • Fax:
Mailing address:
  • Phone: 772-286-7326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS5685
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number308899
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: