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NPI Code Detail

MEDICARE: SETH WILLIAM JELINEK M.D.

MEDICARE:   SETH WILLIAM JELINEK  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician074363GA
2207R00000XInternal Medicine PhysicianME138257FL

General Provider Information

NPI Number : 1144589854
Entity Type Code : Individual
Provider Name (Legal Business Name) : SETH WILLIAM JELINEK M.D.
Provider Business Mailing Address
First Line : 13861 PLANTATION RD STE 104
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4342
Country : US
Telephone Number : 239-225-1306
Fax Number :
Provider Business Practice Location Address
First Line : 13861 PLANTATION RD STE 104
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4342
Country : US
Telephone Number : 239-225-1306
Fax Number : 239-768-1313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2012
Last Update Date : 02/01/2019

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