Healthcare Provider Details

I. General information

NPI: 1245346915
Provider Name (Legal Business Name): CARYN E SELICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 BILTMORE WAY PH 3A
CORAL GABLES FL
33134-5722
US

IV. Provider business mailing address

550 BILTMORE WAY PH 3A
CORAL GABLES FL
33134-5722
US

V. Phone/Fax

Practice location:
  • Phone: 305-800-2229
  • Fax: 305-847-3873
Mailing address:
  • Phone: 305-800-2229
  • Fax: 305-847-3873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number181506
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number181506
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberME110940
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: