Provider Demographics
NPI:1568794022
Name:SCHMALTZ, MEGHAN ELIZABETH (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:SCHMALTZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 917770 STE 200
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:509 S ARMENIA AVE
Practice Address - Street 2:STE 200
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3395
Practice Address - Country:US
Practice Address - Phone:813-353-1515
Practice Address - Fax:813-353-0485
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9196279363L00000X
FLAPRN9196279363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY0KP6OtherBLUE CROSS BLUE SHIELD
FL112358200Medicaid