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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, M.D., P.A.

NPI # 1356482103
LBN Legal business name LEE D. ETTINGER, M.D., P.A.
Authorized official CHRISTIE BENOIT - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/12/2007
Last updated 08/20/2018 - About 8 years ago
Identifiers
FL License # ME35386
FL Medicaid 067872400
FL Other 110007848 MEDICARE RAILROAD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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