Provider Demographics
NPI:1073587952
Name:OPPENHEIM, SETH H (MD)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:H
Last Name:OPPENHEIM
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 1:779 CORTARO DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-6812
Mailing Address - Country:US
Mailing Address - Phone:813-213-0020
Mailing Address - Fax:813-642-7357
Practice Address - Street 1:779 CORTARO DR
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-6812
Practice Address - Country:US
Practice Address - Phone:813-213-0020
Practice Address - Fax:813-642-7357
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038183207W00000X
FLME127547207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9ADXCOtherFLORIDA BLUE
FL020954500Medicaid
VA00X550R07Medicare PIN
VAC36486Medicare UPIN