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NPI Code Detail

MEDICARE: SEBASTIAN AFONSO PAC

MEDICARE: SEBASTIAN AFONSO PAC
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
1363A00000XPhysician Assistant8894GA

General Provider Information

NPI Number : 1700360526
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEBASTIAN AFONSO PAC
Provider Business Mailing Address
First Line : 2505 HARRISON AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4464
Country : US
Telephone Number : 850-233-3376
Fax Number : 850-522-8354
Provider Business Practice Location Address
First Line : 658 N CHASE ST STE 102
Second Line :
City : ATHENS
State : GA
Zip : 30601-1960
Country : US
Telephone Number : 850-233-3376
Fax Number : 850-522-8354
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2018
Last Update Date : 03/05/2026

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Directions to “ SEBASTIAN AFONSO PAC” Practice Location

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