MEDICARE: DAVID LETTS 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	207P00000X	Emergency Medicine Physician	ME47494	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
2	58495	OTHER	FL	BLUECROSS BLUESHIELD

General Provider Information

NPI Number	:	1588667216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID LETTS MD

Provider Business Mailing Address
First Line	:	6813 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-5603
Country	:	US
Telephone Number	:	941-923-5861
Fax Number	:	941-926-4547

Provider Business Practice Location Address
First Line	:	6813 S TAMIAMI TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-5603
Country	:	US
Telephone Number	:	941-923-5861
Fax Number	:	941-926-4547

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

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	10/16/2012

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