Provider Demographics
NPI:1871235598
Name:SEBASTIAN ENCARNACION, JOSE MOISES (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MOISES
Last Name:SEBASTIAN ENCARNACION
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BISCAYNE BLVD APT 1102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-4570
Mailing Address - Country:US
Mailing Address - Phone:787-662-3772
Mailing Address - Fax:
Practice Address - Street 1:3400 GULF TO BAY BLVD RM 3608
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-4514
Practice Address - Country:US
Practice Address - Phone:813-574-5270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program