=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225099104
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SEIN WIN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/30/2006
-----------------------------------------------------
Last Update Date | 05/23/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 675 S BABCOCK ST
-----------------------------------------------------
City | MELBOURNE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32901-1459
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 321-952-1192
-----------------------------------------------------
Fax | 321-952-8937
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 903 W MARTIN ST # MS 49-2
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78207-0903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-358-5909
-----------------------------------------------------
Fax | 210-358-5940
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | N0558
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | ME95288
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------