Provider Demographics
NPI:1659572022
Name:SCHROEDER, ERIC RYAN (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:RYAN
Last Name:SCHROEDER
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 1:7330 SW 62ND PL
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4825
Mailing Address - Country:US
Mailing Address - Phone:305-663-1001
Mailing Address - Fax:305-663-1007
Practice Address - Street 1:7330 SW 62ND PL
Practice Address - Street 2:SUITE 310
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4825
Practice Address - Country:US
Practice Address - Phone:305-663-1001
Practice Address - Fax:305-663-1007
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98897207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFB703ZMedicare UPIN