Healthcare Provider Details

I. General information

NPI: 1578851812
Provider Name (Legal Business Name): SEBASTIAN ROOSEVELT ALSTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5996 ANSEL FERREL RD
TALLAHASSEE FL
32309-8934
US

IV. Provider business mailing address

5996 ANSEL FERREL RD
TALLAHASSEE FL
32309-8934
US

V. Phone/Fax

Practice location:
  • Phone: 850-668-1550
  • Fax:
Mailing address:
  • Phone: 850-668-1550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberME 102905
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: