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Contact Information

LEE D. ETTINGER, M.D., P.A.
914 MAR WALT DR # C
FORT WALTON BEACH, FL32547
 Phone: 850-863-3199
 Fax: 850-863-3196
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for LEE D ETTINGER MD PA · (Female)

NPI # 1356482103
Status Active
Credentials
Entity Individual
Enumeration date 02/12/2007
Last updated 08/20/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # ME35386
  • FL Medicaid 067872400
  • FL Other 110007848 MEDICARE RAILROAD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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