Provider Demographics
NPI:1255334348
Name:SELTZER, PAUL DAVID (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:DAVID
Last Name:SELTZER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 45TH ST
Mailing Address - Street 2:STE 101
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2028
Mailing Address - Country:US
Mailing Address - Phone:561-848-0330
Mailing Address - Fax:561-848-0420
Practice Address - Street 1:2051 45TH ST
Practice Address - Street 2:STE 101
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2028
Practice Address - Country:US
Practice Address - Phone:561-848-0330
Practice Address - Fax:561-848-0420
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0004888207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD27389Medicare UPIN
FL82763Medicare ID - Type Unspecified