MEDICARE: MR. WAYNE SEWARD JR. PA-C

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	208M00000X	Hospitalist Physician	PA9108615	FL
2	363AS0400X	Surgical Physician Assistant	PA9108615	FL
3	363A00000X	Physician Assistant	PA9108615	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	UQ983	OTHER	FL	MEDICARE HF

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821481615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WAYNE SEWARD JR. PA-C

Provider Business Mailing Address
First Line	:	6321 DANIELS PKWY STE 200
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4710
Country	:	US
Telephone Number	:	239-416-8101
Fax Number	:	239-402-8601

Provider Business Practice Location Address
First Line	:	200 3RD AVE W STE 210
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34205-8633
Country	:	US
Telephone Number	:	941-792-0340
Fax Number	:

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

Provider Enumeration Date	:	03/18/2015
Last Update Date	:	06/30/2025

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Directions to “ MR. WAYNE SEWARD JR. PA-C” Practice Location

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