Provider Demographics
NPI:1376634246
Name:SCHWARTZ AND SCHWARTZ MDPA
Entity Type:Organization
Organization Name:SCHWARTZ AND SCHWARTZ MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/ MED ASST
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-936-1700
Mailing Address - Street 1:38 BARKLEY CIR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-7526
Mailing Address - Country:US
Mailing Address - Phone:239-936-1700
Mailing Address - Fax:239-939-9062
Practice Address - Street 1:38 BARKLEY CIR
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7526
Practice Address - Country:US
Practice Address - Phone:239-936-1700
Practice Address - Fax:239-939-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77271Medicare ID - Type UnspecifiedMEDICARE PROV NUMBER