Provider Demographics
NPI:1053626713
Name:SCHULTZ, MICHAEL GREGORY (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GREGORY
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11806 RIVE ISLE RUN
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-2626
Mailing Address - Country:US
Mailing Address - Phone:414-750-3072
Mailing Address - Fax:
Practice Address - Street 1:2800 N MACDILL AVE.
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-828-5367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program