Provider Demographics
NPI:1275719890
Name:SCHOTTEL, JASON DAVID (ARNP)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:DAVID
Last Name:SCHOTTEL
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 DUNLAWTON AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4234
Mailing Address - Country:US
Mailing Address - Phone:904-333-4031
Mailing Address - Fax:
Practice Address - Street 1:851 DUNLAWTON AVE STE 104
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127
Practice Address - Country:US
Practice Address - Phone:904-333-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12138111N00000X
FL9176378163WG0000X
FLAPRN11000698363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No111N00000XChiropractic ProvidersChiropractor
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice