Provider Demographics
NPI:1942341862
Name:SCHMIDT, SHARON D (LM)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:D
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 UNIVERSITY BLVD W
Mailing Address - Street 2:SUITE 5
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2041
Mailing Address - Country:US
Mailing Address - Phone:904-855-4211
Mailing Address - Fax:904-562-3393
Practice Address - Street 1:2221 UNIVERSITY BLVD W
Practice Address - Street 2:SUITE 5
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2041
Practice Address - Country:US
Practice Address - Phone:904-855-4211
Practice Address - Fax:904-562-3393
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW0088175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340091300Medicaid