Provider Demographics
NPI:1568842904
Name:SCHLUB, RILEY AUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:AUSTIN
Last Name:SCHLUB
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 1:1715 EAGLE HARBOR PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-4324
Mailing Address - Country:US
Mailing Address - Phone:904-215-2422
Mailing Address - Fax:
Practice Address - Street 1:1715 EAGLE HARBOR PKWY STE A
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-4324
Practice Address - Country:US
Practice Address - Phone:904-215-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1548762086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery