MEDICARE: SEEKO

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1720599459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEEKO

Provider Business Mailing Address
First Line	:	PO BOX 21279
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33742-1279
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11400 4TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33716-2920
Country	:	US
Telephone Number	:	954-560-0767
Fax Number	:	954-560-0767

Authorized Official
Title or Position	:	PRIMARY CARE PROVIDER
Name	:	ANDY DUCLOS
Credential	:
Telephone Number	:	954-560-0767

Provider Enumeration Date	:	10/20/2017
Last Update Date	:	03/13/2018

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Directions to “SEEKO ” Practice Location

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