Provider Demographics
NPI:1063501518
Name:SELDIN, LIANA KORYTOWSKI (DPM)
Entity Type:Individual
Prefix:
First Name:LIANA
Middle Name:KORYTOWSKI
Last Name:SELDIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 CORAL WAY STE 309
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3214
Mailing Address - Country:US
Mailing Address - Phone:305-856-6441
Mailing Address - Fax:305-854-3880
Practice Address - Street 1:2828 CORAL WAY STE 309
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3214
Practice Address - Country:US
Practice Address - Phone:305-856-6441
Practice Address - Fax:305-854-3880
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-0003037213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340494300Medicaid
FLU27332Medicare PIN
FL340494300Medicaid
FL1148440001Medicare NSC