| Doctor Name: | IDA SEBASTIAN |
| NPI Number: | 1407803430 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 28608 |
| Business Practice Address: | 1250 Southwinds Drive Lantana Health Department Lantana, FL - 33462 |
| Business Phone Number: | 5615476800 |
| Business Fax Number: | |
| Mailing Address: | 4526 Saint Andrews Drive, BOYNTON BEACH |
| State: | FL |
| Postal Code: | 334364426 |
| Phone Number: | 5617373174 |
| Fax Number: | |
| NPI Enumeration Date: | 05/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VX0000X |
| License Number: | 28608 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Obstetrics |
| Taxonomy Definition: | |