Healthcare Provider Details

I. General information

NPI: 1225477094
Provider Name (Legal Business Name): TAMARA ELIZABETH SEALY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38240 DAUGHTERY RD
ZEPHYRHILLS FL
33540-1367
US

IV. Provider business mailing address

38240 DAUGHTERY RD
ZEPHYRHILLS FL
33540-1367
US

V. Phone/Fax

Practice location:
  • Phone: 813-788-3582
  • Fax:
Mailing address:
  • Phone: 813-788-3582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTRN18615
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number074991
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME155343
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: