Provider Demographics
NPI:1265783195
Name:SELTZER, CASEY LAUREN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CASEY
Middle Name:LAUREN
Last Name:SELTZER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1919 E HWY 50 STE 203
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1975
Mailing Address - Country:US
Mailing Address - Phone:407-303-1380
Mailing Address - Fax:407-303-1385
Practice Address - Street 1:1919 E HWY 50 STE 203
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1975
Practice Address - Country:US
Practice Address - Phone:407-303-1380
Practice Address - Fax:407-303-1385
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106787363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant