Provider Demographics
NPI:1457332488
Name:SCHILLINGER, BRENT MARC (MD)
Entity Type:Individual
Prefix:
First Name:BRENT
Middle Name:MARC
Last Name:SCHILLINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 S FEDERAL HWY STE 8
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-3320
Mailing Address - Country:US
Mailing Address - Phone:561-278-1362
Mailing Address - Fax:561-278-4383
Practice Address - Street 1:3100 S FEDERAL HWY STE 8
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3320
Practice Address - Country:US
Practice Address - Phone:561-278-1362
Practice Address - Fax:561-278-4383
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0041920207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
612761ZMedicare ID - Type Unspecified
D57168Medicare UPIN