Healthcare Provider Details

I. General information

NPI: 1780612218
Provider Name (Legal Business Name): STEVEN J. SELTZER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 7TH ST S STE 400
ST PETERSBURG FL
33701-4734
US

IV. Provider business mailing address

1301 2ND AVE SW
LARGO FL
33770-3120
US

V. Phone/Fax

Practice location:
  • Phone: 727-553-7420
  • Fax: 727-553-7419
Mailing address:
  • Phone: 727-584-7706
  • Fax: 727-585-8713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS6840
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: