1972516979 NPI number — DR. ROBERT JOSEPH SCHRAMM MD

Table of content: MRS. KRISTEN MARIE CONNERS M.S., CCC-A (NPI 1164635280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972516979 NPI number — DR. ROBERT JOSEPH SCHRAMM MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHRAMM
Provider First Name:
ROBERT
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1972516979
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 GLADES RD
Provider Second Line Business Mailing Address:
SUITE 420
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33431-6465
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-368-7006
Provider Business Mailing Address Fax Number:
561-405-3128

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
660 GLADES RD
Provider Second Line Business Practice Location Address:
SUITE 420
Provider Business Practice Location Address City Name:
BOCA RATON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33431-6465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-368-7006
Provider Business Practice Location Address Fax Number:
561-368-9010
Provider Enumeration Date:
08/14/2006

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: 207K00000X , with the licence number:  ME 0062848 , 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: 009035 . This is a "NEIGHBORHOOD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 18693 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 4373241 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0202112 . This is a "UNITED" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P2259144 . This is a "OXFORD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 113183 . This is a "AMERIGROUP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 372158200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: F61935 . This is a "VISTA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 101445 . This is a "FIRST HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 01427 . This is a "WELLCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 14754 . This is a "FOUNDATION" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 650478208 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 004920700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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