Provider Demographics
NPI:1205033412
Name:WEINTRITT-DAVIS, LINDSEY M (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:M
Last Name:WEINTRITT-DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LINDSEY
Other - Middle Name:M
Other - Last Name:WEINTRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1770
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32402-1770
Mailing Address - Country:US
Mailing Address - Phone:850-747-4905
Mailing Address - Fax:850-747-4907
Practice Address - Street 1:527 N PALO ALTO AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3639
Practice Address - Country:US
Practice Address - Phone:850-747-4905
Practice Address - Fax:850-747-4907
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN11518207R00000X
FLME1165482085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009142100Medicaid
FL14R2YOtherBCBS
FLHJ682YOtherMEDICARE FL
FLHJ682ZOtherMEDICARE FL
FLHJ682XOtherMEDICARE FL
FL14R2YOtherBCBS