Individual
DERK ESTES SEABOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-4456
Mailing address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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