Provider Demographics
NPI:1588659502
Name:SOUTHWEST FLORIDA EMERGENCY PHYSICIANS, PA
Entity Type:Organization
Organization Name:SOUTHWEST FLORIDA EMERGENCY PHYSICIANS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-266-9879
Mailing Address - Street 1:P.O. BOX 634633
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13681 DOCTORS WAY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4300
Practice Address - Country:US
Practice Address - Phone:239-768-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL064433100Medicaid
FL00215OtherBCBS GROUP
FLCB5038OtherRR MCR GROUP
FL=========OtherCHAMPUS GROUP
FL=========OtherCHAMPUS GROUP