Provider Demographics
NPI:1801214465
Name:SCHIERLINGER PODIATRY CENTER
Entity Type:Organization
Organization Name:SCHIERLINGER PODIATRY CENTER
Other - Org Name:KURT SCHIERLINGER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHIERLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:386-423-9573
Mailing Address - Street 1:201 S RIDGEWOOD AVE
Mailing Address - Street 2:SUITE 1 & 2
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32132-1946
Mailing Address - Country:US
Mailing Address - Phone:386-423-9573
Mailing Address - Fax:386-423-6823
Practice Address - Street 1:201 S RIDGEWOOD AVE
Practice Address - Street 2:SUITE 1 & 2
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32132-1946
Practice Address - Country:US
Practice Address - Phone:386-423-9573
Practice Address - Fax:386-423-6823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0001828213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL480005753OtherRAILROAD
1801214465OtherGROUP NPI
1508800053OtherINDIVIDUAL NPI
1457616922OtherINDIVIDUAL NPI
FLHU103AMedicare PIN
1508800053OtherINDIVIDUAL NPI
FL6073590001Medicare NSC
FL480005753OtherRAILROAD