Paul D Fuldauer, RD is a medicare enrolled "Dietitian, Registered" provider in Deltona, Florida. His current practice location is
3300 E Halifax Crossing Blvd, Deltona, Florida. You can reach out to his office (for appointments etc.) via phone at
(386) 425-6000.
Paul D Fuldauer is licensed to practice in Florida (license number 5965) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1578294666.
Healthcare Provider's Profile
| Full Name | Paul D Fuldauer |
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| Gender | Male |
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| Speciality | Dietitian, Registered |
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| Location | 3300 E Halifax Crossing Blvd, Deltona, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1578294666
- Provider Enumeration Date: 06/21/2022
- Last Update Date: 06/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 7214311729
- Enrollment ID: I20220901001867
Medical Identifiers
Medical identifiers for Paul D Fuldauer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1578294666 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 5965 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Paul D Fuldauer allows following entities to bill medicare on his behalf.
| Provider Name | Florida Clinical Practice Association Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1063463768
PECOS PAC ID: 0345146254
Enrollment ID: O20031211000099 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Paul D Fuldauer is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Paul D Fuldauer, RD
303 N Clyde Morris Blvd,
Daytona Beach, FL 32114-2709
Ph: (386) 425-4000 | Paul D Fuldauer, RD
3300 E Halifax Crossing Blvd,
Deltona, FL 32725-2911
Ph: (386) 425-6000 |
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