Provider Demographics
NPI:1215041074
Name:SCHWARTZ, JEFFREY M (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:M
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4729 US HIGHWAY 98 S
Mailing Address - Street 2:SUITE 105
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812-4323
Mailing Address - Country:US
Mailing Address - Phone:863-619-9800
Mailing Address - Fax:863-619-9840
Practice Address - Street 1:4729 US HIGHWAY 98 S
Practice Address - Street 2:SUITE 105
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4323
Practice Address - Country:US
Practice Address - Phone:863-619-9800
Practice Address - Fax:863-619-9840
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME50872208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME50872OtherLICENSE NUMBER
FLME50872OtherLICENSE NUMBER