Provider Demographics
NPI:1760954127
Name:SEIDT, IRENE (APRN)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:SEIDT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2078 LOS LOMAS DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-4118
Mailing Address - Country:US
Mailing Address - Phone:863-221-1904
Mailing Address - Fax:
Practice Address - Street 1:385 CYPRESS GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-4452
Practice Address - Country:US
Practice Address - Phone:863-291-0140
Practice Address - Fax:863-299-1694
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034076363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology