Provider Demographics
NPI:1629052998
Name:SCHULZ, ROBERT MICHAEL I (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:SCHULZ
Suffix:I
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19808 MORDEN BLUSH DRIVE
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-9093
Mailing Address - Country:US
Mailing Address - Phone:813-926-3434
Mailing Address - Fax:727-376-3009
Practice Address - Street 1:4107 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1722
Practice Address - Country:US
Practice Address - Phone:727-376-3131
Practice Address - Fax:727-376-3131
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC001366152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT77507Medicare UPIN
FL19739Medicare ID - Type Unspecified