Provider Demographics
NPI:1326652546
Name:SCHILDHAUSE, EVA
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:SCHILDHAUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 ARLINGTON EXPY
Mailing Address - Street 2:STE B105 PMB2352
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5824
Mailing Address - Country:US
Mailing Address - Phone:904-651-9475
Mailing Address - Fax:
Practice Address - Street 1:9250 SW 136TH STREET CIR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-5824
Practice Address - Country:US
Practice Address - Phone:904-651-9475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW172611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical