Provider Demographics
NPI:1023013851
Name:SCHWARTZ, STEVEN H (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:H
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SHIRCLIFF WAY
Mailing Address - Street 2:STE 122
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4757
Mailing Address - Country:US
Mailing Address - Phone:904-388-3109
Mailing Address - Fax:904-388-9132
Practice Address - Street 1:3 SHIRCLIFF WAY
Practice Address - Street 2:STE 122
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4757
Practice Address - Country:US
Practice Address - Phone:904-388-3109
Practice Address - Fax:904-388-9132
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP0001568152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL540001030OtherRAILROAD MEDICARE
FL620310800Medicaid
FL20104ZMedicare PIN
FLU69328Medicare UPIN