Provider Demographics
NPI:1750312526
Name:SCHMIDT, SIEGFRIED O F (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:SIEGFRIED
Middle Name:O F
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:SIEGFRIED
Other - Middle Name:OF
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-265-9475
Mailing Address - Fax:352-265-9476
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-365-9475
Practice Address - Fax:352-265-9476
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME58468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370521800Medicaid
68592ZMedicare PIN
F30680Medicare UPIN