Healthcare Provider Details

I. General information

NPI: 1679672315
Provider Name (Legal Business Name): DANIEL BENNETT SEFF D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 05/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 CASA ALOMA WAY SUITE 500
WINTER PARK FL
32792-2223
US

IV. Provider business mailing address

2828 CASA ALOMA WAY SUITE 500
WINTER PARK FL
32792-2223
US

V. Phone/Fax

Practice location:
  • Phone: 407-678-9595
  • Fax: 407-678-4448
Mailing address:
  • Phone: 407-678-9595
  • Fax: 407-678-4448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberOS0004609
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: