Lee D. Ettinger, M.D., P.a.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

ME35386 Issued in FL

Legal business name

LEE D. ETTINGER, M.D., P.A.

Practice address

914 Mar Walt Dr # C
Fort Walton Beach, FL 32547

Phone

(850) 863-3199

Fax

(850) 863-3196

NPI assigned

Feb 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christie Benoit

Title

Manager

Phone

(850) 974-7120

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gustavo F Ros, M.D.

  • Internal Medicine Physician
  • Fort Walton Beach, FL
  • NPI 1912902982
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534723200000",
    "number": "1356482103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 792",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325790792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 MAR WALT DR # C",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "32547",
            "telephone_number": "850-863-3199",
            "fax_number": "850-863-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE D. ETTINGER, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2018-08-20",
        "status": "A",
        "authorized_official_last_name": "BENOIT",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "850-974-7120"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME35386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067872400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110007848",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Lynn Leake
• Learning to Heal Therapy, LLC
• Matthew Aaron Leary, PT
• Laura Lynne Lebrasseur, ITDS
• Alexandria Ledford
• Whitney T Lee, ATC
• Mary Susan Leger
• Leif Erik Sternung
• Delisha Woodson Leon
• Mary Elizabeth Leonpacher

• Pulmonary Disease Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Pulmonary Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.