MEDICARE: DALLAS ELLEN SEIDMAN PARKER 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

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	:	1356920227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALLAS ELLEN SEIDMAN PARKER PA-C

Provider Business Mailing Address
First Line	:	92 E MITCHELL HAMMOCK RD STE 1006
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-9756
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	92 E MITCHELL HAMMOCK RD STE 1006
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-9756
Country	:	US
Telephone Number	:	321-364-0022
Fax Number	:

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

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	06/11/2025

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Directions to “ DALLAS ELLEN SEIDMAN PARKER PA-C” Practice Location

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