Basic Information
| Provider Information | |||||||||
| NPI: | 1750657383 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEIFERT | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | PATRICK | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 SW ARCHER RD BOX 100275 | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326100275 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522737839 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1600 SW ARCHER RD BOX 100275 | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326104742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139743680 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | ME123797 | FL | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 021449900 | 05 | FL | MEDICAID |