Provider Demographics
NPI:1386679249
Name:SCHWENKER & STAVOY, MD, PA
Entity Type:Organization
Organization Name:SCHWENKER & STAVOY, MD, PA
Other - Org Name:HALIFAX OB/GYN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:P
Authorized Official - Last Name:CARBIENER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-252-4701
Mailing Address - Street 1:1890 LPGA BLVD
Mailing Address - Street 2:STE 160
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-7130
Mailing Address - Country:US
Mailing Address - Phone:386-252-4701
Mailing Address - Fax:386-253-9410
Practice Address - Street 1:1890 LPGA BLVD
Practice Address - Street 2:STE 160
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-7130
Practice Address - Country:US
Practice Address - Phone:386-252-4701
Practice Address - Fax:386-253-9410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77459Medicare ID - Type Unspecified