MEDICARE: MRS. CASEY LAUREN SELTZER PA-C

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
1	363A00000X	Physician Assistant	PA9106787	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265783195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASEY LAUREN SELTZER PA-C

Provider Business Mailing Address
First Line	:	1919 E HWY 50 STE 203
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1975
Country	:	US
Telephone Number	:	407-303-1380
Fax Number	:	407-303-1385

Provider Business Practice Location Address
First Line	:	1919 E HWY 50 STE 203
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-1975
Country	:	US
Telephone Number	:	407-303-1380
Fax Number	:	407-303-1385

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2012
Last Update Date	:	07/14/2022

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