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General NPI Number Information
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NPI Number | 1982700407
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Entity Type | Individual
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Provider Name | BRIAN SELIUS DO
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 2780 CLEVELAND AVE SUITE 709
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City | FORT MEYERS
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State | FL
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Zip | 33901-5857
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Country | US
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Telephone | 239-343-3831
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Fax | 239-343-2301
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-343-3831
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Fax | 239-343-2301
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34005316
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS10364
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License Number State | FL
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