Provider Demographics
NPI:1831118629
Name:SEIDNER, DAVID (PT, DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SEIDNER
Suffix:
Gender:M
Credentials:PT, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2970
Mailing Address - Country:US
Mailing Address - Phone:954-951-6699
Mailing Address - Fax:
Practice Address - Street 1:7447 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2970
Practice Address - Country:US
Practice Address - Phone:954-951-6699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005693111N00000X
FLPT0005152225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00123606OtherRAILROAD MEDICARE
FL65-0415839OtherTAX ID#
FLP00189999OtherRAIL ROAD MEDICARE
FL65-0016914OtherTAX ID#
FL22195Medicare ID - Type UnspecifiedPROVIDER NUMBER
FL65-0415839OtherTAX ID#
FLY2584Medicare PIN