Provider Demographics
NPI:1578545851
Name:SCHADER, ROBERT B (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:SCHADER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6356 MANOR LN
Mailing Address - Street 2:STE 102
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4960
Mailing Address - Country:US
Mailing Address - Phone:305-661-5994
Mailing Address - Fax:505-661-9779
Practice Address - Street 1:7325 SW 63RD AVE
Practice Address - Street 2:STE 203
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4811
Practice Address - Country:US
Practice Address - Phone:305-661-5994
Practice Address - Fax:305-661-9779
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 22182207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05610700Medicaid
FL05610700Medicaid
92104Medicare ID - Type Unspecified