Provider Demographics
NPI:1619063401
Name:SCHILLER, JEAN SAUL (ARNP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:SAUL
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:
Other - Last Name:SAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:86 W UNDERWOOD ST
Mailing Address - Street 2:MP 80
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2008
Mailing Address - Country:US
Mailing Address - Phone:321-843-5270
Mailing Address - Fax:321-843-5177
Practice Address - Street 1:86 W UNDERWOOD ST
Practice Address - Street 2:MP 80
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2008
Practice Address - Country:US
Practice Address - Phone:321-843-5270
Practice Address - Fax:321-843-5177
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1955492363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302589600Medicaid
FLARNP1955492OtherMEDICAL LICENSE
FL302589600Medicaid
FL302589600Medicaid
FLY8971Medicare UPIN
FLE1508XMedicare PIN