Provider Demographics
NPI:1932175890
Name:SELESNICK, F HARLAN (MD)
Entity type:Individual
Prefix:DR
First Name:F HARLAN
Middle Name:
Last Name:SELESNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100905
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0905
Mailing Address - Country:US
Mailing Address - Phone:786-268-6200
Mailing Address - Fax:
Practice Address - Street 1:1150 CAMPO SANO AVE FL 2
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1174
Practice Address - Country:US
Practice Address - Phone:786-308-3350
Practice Address - Fax:786-308-3362
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046044207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD64011Medicare UPIN
FL96861Medicare ID - Type Unspecified