Provider Demographics
NPI:1891727509
Name:SCHRYVER, MICHELE LEE (PA)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LEE
Last Name:SCHRYVER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:LEE
Other - Last Name:RYCZEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:8200 WORLD CENTER DRIVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821
Mailing Address - Country:US
Mailing Address - Phone:074-651-1104
Mailing Address - Fax:407-465-1222
Practice Address - Street 1:8200 WORLD CENTER DRIVE
Practice Address - Street 2:SUITE 170
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821
Practice Address - Country:US
Practice Address - Phone:074-651-1104
Practice Address - Fax:407-465-1222
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102715363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292021200Medicaid
FLU25053Medicare ID - Type Unspecified
FL292021200Medicaid