Provider Demographics
NPI:1376906438
Name:ALLSEITS, EMMANUELLE (MD)
Entity Type:Individual
Prefix:
First Name:EMMANUELLE
Middle Name:
Last Name:ALLSEITS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-6381
Mailing Address - Country:US
Mailing Address - Phone:772-742-9275
Mailing Address - Fax:
Practice Address - Street 1:5979 VINELAND RD STE 208
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7855
Practice Address - Country:US
Practice Address - Phone:407-745-1171
Practice Address - Fax:407-745-0712
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA161551207Q00000X
FLME151011207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine