MEDICARE: EMMANUELLE ALLSEITS MD

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	207Q00000X	Family Medicine Physician	ME151011	FL
2	207Q00000X	Family Medicine Physician	A161551	CA

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	:	1376906438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUELLE ALLSEITS MD

Provider Business Mailing Address
First Line	:	3255 S US HIGHWAY 1
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6381
Country	:	US
Telephone Number	:	772-742-9275
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 TURKEY LAKE RD STE 110
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-4205
Country	:	US
Telephone Number	:	407-745-1171
Fax Number	:	407-745-0712

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

Provider Enumeration Date	:	04/05/2016
Last Update Date	:	09/11/2024

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Directions to “ EMMANUELLE ALLSEITS MD” Practice Location

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