MEDICARE: JOEL L SEBASTIEN MD

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	208600000X	Surgery Physician	ME89364	FL
2	2086S0127X	Trauma Surgery Physician	ME89364	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1639166739	OTHER	FL	MULTIPLAN
2	43297	OTHER	FL	BCBS
3	P00908241	OTHER	FL	RAILROAD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1639166739	OTHER	FL	TRICARE
6	1639166739	OTHER	FL	VHN
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639166739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL L SEBASTIEN MD

Provider Business Mailing Address
First Line	:	PO BOX 9671
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32120-9671
Country	:	US
Telephone Number	:	386-676-7130
Fax Number	:	386-676-7125

Provider Business Practice Location Address
First Line	:	201 NORTH CLYDE MORRIS BLVD.
Second Line	:	SUITE 100
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32114-2724
Country	:	US
Telephone Number	:	386-238-3295
Fax Number	:	386-328-3273

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	03/04/2016

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Directions to “ JOEL L SEBASTIEN MD” Practice Location

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