Basic Information
Provider Information
NPI: 1316952047
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SETLIK
FirstName: JENNIFER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 191
Address2: PROVIDER ENROLLMENT DEPARTMENT
City: ROCKLAND
State: DE
PostalCode: 197320191
CountryCode: US
TelephoneNumber: 3026515985
FaxNumber: 3026514945
Practice Location
Address1: 13535 NEMOURS PKWY
Address2:  
City: ORLANDO
State: FL
PostalCode: 328277402
CountryCode: US
TelephoneNumber: 4075674000
FaxNumber: 4075675924
Other Information
ProviderEnumerationDate: 07/30/2006
LastUpdateDate: 05/02/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0204XOH35.088360OHN Allopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
207PP0204XME118849FLY Allopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine

No ID Information.


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