Healthcare Provider Details

I. General information

NPI: 1477226298
Provider Name (Legal Business Name): OPAL SEKLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S PENINSULA DR
DAYTONA BEACH FL
32118-4422
US

IV. Provider business mailing address

295 NE IVANHOE BLVD APT 505
ORLANDO FL
32804-6478
US

V. Phone/Fax

Practice location:
  • Phone: 386-310-3529
  • Fax: 386-310-2106
Mailing address:
  • Phone: 407-310-3108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME165059
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: