MEDICARE: DAVID SELTZER D.O.

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	2084P0800X	Psychiatry Physician	OS9629	FL
2	2084P0800X	Psychiatry Physician	1866	ME

General Provider Information

NPI Number	:	1710915988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID SELTZER D.O.

Provider Business Mailing Address
First Line	:	12734 KENWOOD LN
Second Line	:	STE. 84
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5666
Country	:	US
Telephone Number	:	239-936-5250
Fax Number	:	239-936-9970

Provider Business Practice Location Address
First Line	:	12734 KENWOOD LN
Second Line	:	STE. 84
City	:	FORT MYERS
State	:	FL
Zip	:	33907-5666
Country	:	US
Telephone Number	:	239-936-5250
Fax Number	:	239-936-9970

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/08/2007

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Directions to “ DAVID SELTZER D.O.” Practice Location

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