MEDICARE: DR. MICHAEL ANTHONY SEISE PHARMD

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	1835P1200X	Pharmacotherapy Pharmacist	PS38398	FL

General Provider Information

NPI Number	:	1790971331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ANTHONY SEISE PHARMD

Provider Business Mailing Address
First Line	:	16652 IVY LAKE DR
Second Line	:
City	:	ODESSA
State	:	FL
Zip	:	33556-6018
Country	:	US
Telephone Number	:	813-926-5357
Fax Number	:

Provider Business Practice Location Address
First Line	:	5109 W LEMON ST STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-1102
Country	:	US
Telephone Number	:	813-463-1266
Fax Number	:

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

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	09/18/2007

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