MEDICARE: DR. MICHELE L SELSOR DPM

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	213E00000X	Podiatrist	PO2916	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	480034898	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	4687950002	OTHER	DMEPOS

General Provider Information

NPI Number	:	1407854839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE L SELSOR DPM

Provider Business Mailing Address
First Line	:	5851 93RD AVE N
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33782-4905
Country	:	US
Telephone Number	:	727-321-9488
Fax Number	:	727-321-2033

Provider Business Practice Location Address
First Line	:	7744 66TH ST N
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-3100
Country	:	US
Telephone Number	:	727-321-9488
Fax Number	:	727-321-2033

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

Provider Enumeration Date	:	07/10/2005
Last Update Date	:	03/03/2026

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