Provider Demographics
NPI:1811738024
Name:ARTMAN, SEAN MICHAEL
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:MICHAEL
Last Name:ARTMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 BELGIAN DR APT 6110
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3418
Mailing Address - Country:US
Mailing Address - Phone:321-501-5190
Mailing Address - Fax:
Practice Address - Street 1:5240 BABCOCK ST NE STE 105
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4615
Practice Address - Country:US
Practice Address - Phone:321-837-3746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1119864106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician