MEDICARE: SEALYM NEUROLOGY & EPILEPSY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	ME88919	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME88919	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1235325804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEALYM NEUROLOGY & EPILEPSY, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 411177
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32941-1177
Country	:	US
Telephone Number	:	321-242-8486
Fax Number	:	321-242-5979

Provider Business Practice Location Address
First Line	:	7000 SPYGLASS CT
Second Line	:	SUITE 350
City	:	MELBOURNE
State	:	FL
Zip	:	32940-8288
Country	:	US
Telephone Number	:	321-242-8486
Fax Number	:	321-242-5979

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. DALWYN M. SEALY
Credential	:	M.D.
Telephone Number	:	321-242-8486

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	03/07/2023

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