Provider Demographics
NPI:1780657882
Name:SCHLUMBOHM, ARLENE G (DO)
Entity Type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:G
Last Name:SCHLUMBOHM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD
Mailing Address - Street 2:SUITE #3004
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1471
Mailing Address - Country:US
Mailing Address - Phone:904-482-1083
Mailing Address - Fax:904-482-1089
Practice Address - Street 1:4205 BELFORT RD
Practice Address - Street 2:#3004
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1471
Practice Address - Country:US
Practice Address - Phone:904-482-1083
Practice Address - Fax:904-482-1089
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0006562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF91770Medicare UPIN
FL80941AMedicare ID - Type Unspecified