1437107653 NPI number — WILLIAM JOHN SCHEER MSW

Table of content: KELLIE JURGONSKI LISW-CP (NPI 1851732671)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437107653 NPI number — WILLIAM JOHN SCHEER MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHEER
Provider First Name:
WILLIAM
Provider Middle Name:
JOHN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
M

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:
1437107653
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10132 S.W. 49TH. MANOR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COOPER CITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33328-3313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-625-8742
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10132 S.W. 49TH. MANOR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOPER CITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33328-3313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-625-8742
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW3634 , 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: Z6095 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".