Provider Demographics
NPI:1477671220
Name:SCHECODNIC, GARY JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:JOHN
Last Name:SCHECODNIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12 S. SEWALLS POINT RD.
Mailing Address - Street 2:
Mailing Address - City:SEWALLS POINT
Mailing Address - State:FL
Mailing Address - Zip Code:34996
Mailing Address - Country:US
Mailing Address - Phone:772-781-2515
Mailing Address - Fax:772-781-2515
Practice Address - Street 1:FLORIDA POWER AND LIGHT COMPANY
Practice Address - Street 2:700 UNIVERSE BLVD. JB JNS
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:561-691-7196
Practice Address - Fax:561-694-4881
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40814207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine