Provider Demographics
NPI:1720361348
Name:SCHROEDER, ERICA L (RPH)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:L
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7956 AMBLESIDE WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7350
Mailing Address - Country:US
Mailing Address - Phone:407-443-9408
Mailing Address - Fax:
Practice Address - Street 1:13950 JOG RD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-5903
Practice Address - Country:US
Practice Address - Phone:561-865-1527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS32238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS32238OtherPHARMACIST LICENSE NUMBER