Provider Demographics
NPI:1487654760
Name:SCHRODER, VINCENT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:SCHRODER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 NW 41ST ST
Mailing Address - Street 2:D-3
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-7495
Mailing Address - Country:US
Mailing Address - Phone:352-372-9797
Mailing Address - Fax:
Practice Address - Street 1:2630 NW 41ST ST
Practice Address - Street 2:D-3
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7495
Practice Address - Country:US
Practice Address - Phone:352-372-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6063103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54519Medicare ID - Type Unspecified