Provider Demographics
NPI:1467737734
Name:SCHOT, RAQUEL MATHEUS (DMD)
Entity Type:Individual
Prefix:
First Name:RAQUEL
Middle Name:MATHEUS
Last Name:SCHOT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 DIAMOND CENTRE CT UNIT 300
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4366
Mailing Address - Country:US
Mailing Address - Phone:239-433-4746
Mailing Address - Fax:
Practice Address - Street 1:6150 DIAMOND CENTRE CT UNIT 300
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4366
Practice Address - Country:US
Practice Address - Phone:239-433-4746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 195521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice