Doctor Name: | MATTHEW SCHROEDER |
NPI Number: | 1063730687 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | PA9107464 |
Business Practice Address: | 346 N Ridgewood Ave Edgewater, FL - 321321671 |
Business Phone Number: | 3864231888 |
Business Fax Number: | |
Mailing Address: | 346 N Ridgewood Ave, EDGEWATER |
State: | FL |
Postal Code: | 321321671 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/06/2010 |
NPI Last Update Date: | 10/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA9107464 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |