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NPI Code Detail

MEDICARE: SEAN PAUL O'LEARY MD

MEDICARE:   SEAN PAUL O'LEARY  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
1390200000XStudent in an Organized Health Care Education/Training Program
2208100000XPhysical Medicine & Rehabilitation PhysicianME168441FL

General Provider Information

NPI Number : 1720616881
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN PAUL O'LEARY MD
Provider Business Mailing Address
First Line : 3713 RABBIT RUN CT
Second Line :
City : PACE
State : FL
Zip : 32571-9662
Country : US
Telephone Number : 248-804-3836
Fax Number :
Provider Business Practice Location Address
First Line : 1101 OFFICE WOODS DR
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-5937
Country : US
Telephone Number : 248-804-3936
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2020
Last Update Date : 07/02/2024

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Directions to “ SEAN PAUL O'LEARY MD” Practice Location

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