Provider Demographics
NPI:1164535936
Name:SCHULTZ, ALLEN F (DO)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:F
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 N CONGRESS AVE
Mailing Address - Street 2:SUITE 304B
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3282
Mailing Address - Country:US
Mailing Address - Phone:561-848-1011
Mailing Address - Fax:561-848-9166
Practice Address - Street 1:4700 N CONGRESS AVE
Practice Address - Street 2:SUITE 304B
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3282
Practice Address - Country:US
Practice Address - Phone:561-848-1011
Practice Address - Fax:561-848-9166
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS3284207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063939700Medicaid
FL063939700Medicaid