Provider Demographics
NPI:1700822202
Name:AMY SEINFELD DO PA
Entity Type:Organization
Organization Name:AMY SEINFELD DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEINFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-949-8488
Mailing Address - Street 1:21355 E DIXIE HWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1238
Mailing Address - Country:US
Mailing Address - Phone:305-949-8488
Mailing Address - Fax:305-949-8115
Practice Address - Street 1:21355 E DIXIE HWY
Practice Address - Street 2:SUITE107
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1238
Practice Address - Country:US
Practice Address - Phone:305-949-8488
Practice Address - Fax:305-949-8115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMY SEINFELD DO PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-22
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8323207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7020Medicare ID - Type Unspecified
FLH55974Medicare UPIN