MR. SEAN M WILDER (NPI# 1275916165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275916165 |
| Entity Type | Individual |
| Full Name | MR. SEAN M WILDER |
| Credential | APRN-C |
| Practice Address |
1919 W Swann Ave Fl 2 Tampa FL 33606-2417 |
| Mailing Address |
2995 Drew St Fl 2 Clearwater FL 33759-3012 |
| Practice Telephone | 8132547079 |
| Practice Fax Number | 8134438164 |
| Mailing Telephone | 7275321355 |
| Mailing Fax Number | 8136352613 |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2019-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
28224842A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
APRN11001912 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 102642600 | 05 |
| Street Address |
1919 W SWANN AVE FL 2 |
| City | TAMPA |
| State | FL |
| Zip Code | 33606-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235758749 | Seyed Shayan Ahmad Falasiri | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd. #308, Tampa, FL 33606 | 2020-04-14 |
| 1174156400 | Jessica Styles | Specialist/Technologist | The University of Tampa, 401 W. Kennedy Blvd, Tampa, FL 33606 | 2020-02-14 |
| 1295389757 | David Green | Specialist/Technologist | 401 W. Kennedy Blvd Box: I, Tampa, FL 33606 | 2019-08-01 |
| 1417514720 | Four Winds Counseling LLC | Counselor | 611 West Bay Street, Tampa, FL 33606 | 2019-05-22 |
| 1699238014 | Azubuogu Charles Anudu | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd., Suite 308 Tampa, Fl 33606, Tampa, FL 33606 | 2019-04-11 |
| 1508327883 | D'arcy Jocelyn Arden Wainwright | Student in an Organized Health Care Education/Training Program | 17 David Blvd., Suite 308, Tampa, FL 33606 | 2019-03-28 |
| 1659851772 | Heather Widmer | Counselor | 202 N Howard Ave, Tampa, FL 33606 | 2018-08-17 |
| 1447737291 | Jonathan T Bell | Marriage & Family Therapist | 425 S. Orleans Ave, Tampa, FL 33606 | 2018-07-24 |
| 1184157539 | Alexander Lim | Student in an Organized Health Care Education/Training Program | 17 David Blvd, Suite 308, Tampa, FL 33606 | 2017-04-04 |
| 1760913057 | Melanie Loretta Bradley | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd. Suite 308, University of South Florida, Morsani College of Medicin, Tampa, FL 33606 | 2017-03-27 |
| Find all providers in zip 33606 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932717998 | Anabel Jimenez | Nurse Practitioner | 4221 W Spruce St Apt 2320, Tampa, FL 33607-7253 | 2020-07-16 |
| 1972150050 | Rebecca Rose Amos | Nurse Practitioner | 10631 Parkers Landing Dr Apt 331, Tampa, FL 33615-5838 | 2019-08-22 |
| 1528615184 | Kathleen Smith | Nurse Practitioner | 601 Channelside Walk Way Apt 1438, Tampa, FL 33602-6741 | 2019-08-19 |
| 1962927723 | Mobile Medical Care | Nurse Practitioner | 11671 Declaration Drive, Tampa, FL 33635 | 2017-08-13 |
| 1972986941 | Eland Health Careers Training & Exam Prep LLC | Nurse Practitioner | 1441 E Fletcher Ave Ste 221b, Tampa, FL 33612-8808 | 2015-07-08 |
| 1467796128 | Diane Regina Jackson | Nurse Practitioner | 1248 E Hillsborough Ave, 221, Tampa, FL 33604-7201 | 2012-11-19 |
| 1043474869 | Malini P Mcdonald | Nurse Practitioner | 2901 W Hillsborough Ave, Suite # C, Tampa, FL 33614-6054 | 2008-07-10 |
| 1053424945 | Susan S Bingham | Nurse Practitioner | 7728 Palm River Rd, Tampa, FL 33619-4215 | 2006-08-16 |
| 1003425232 | Sara Elizabeth Graves | Nurse Practitioner | 5106 N Armenia Ave Ste 1, Tampa, FL 33603-1433 | 2020-07-23 |
| 1912523481 | Timothy Bondell | Nurse Practitioner | 12902 Usf Magnolia Dr, Tampa, FL 33612-9416 | 2020-06-22 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.