Healthcare Provider Details

I. General information

NPI: 1124245691
Provider Name (Legal Business Name): NORMAN B SELTZER,M.D.PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 N PENINSULA DR
DAYTONA BEACH FL
32118-3829
US

IV. Provider business mailing address

614 N PENINSULA DR
DAYTONA BEACH FL
32118-3829
US

V. Phone/Fax

Practice location:
  • Phone: 386-257-2602
  • Fax: 386-257-2329
Mailing address:
  • Phone: 386-257-2602
  • Fax: 386-257-2329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberME0060285
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberME0037891
License Number StateFL

VIII. Authorized Official

Name: DR. NORMAN B SELTZER
Title or Position: OWNER
Credential: MD
Phone: 386-257-2602