Provider Demographics
NPI:1679730303
Name:SCHROEDER, RENEE (NP)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 E MARION AVE STE 139
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-3863
Mailing Address - Country:US
Mailing Address - Phone:941-205-2666
Mailing Address - Fax:941-205-2665
Practice Address - Street 1:713 E MARION AVE STE 139
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33950-3863
Practice Address - Country:US
Practice Address - Phone:941-205-2666
Practice Address - Fax:941-205-2665
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO119969363LA2200X
FLARNP9482380363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health