1417188681 NPI number — DREW SCHNITT MD PA

Table of content: (NPI 1417188681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417188681 NPI number — DREW SCHNITT MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DREW SCHNITT MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417188681
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 AVOCADO ISLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33315-1337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-558-6353
Provider Business Mailing Address Fax Number:
206-202-1635

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1150 N 35TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021-5424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-352-3627
Provider Business Practice Location Address Fax Number:
206-202-1635
Provider Enumeration Date:
08/05/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SCHNITT
Authorized Official First Name:
DREW
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
954-558-6353

Provider Taxonomy Codes

  • Taxonomy code: 208200000X , with the licence number:  ME86088 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 265480600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".