Provider Demographics
NPI:1952844961
Name:ALLEN T. SCHWARTZ MD, LLC
Entity Type:Organization
Organization Name:ALLEN T. SCHWARTZ MD, LLC
Other - Org Name:MEDICAL CONCIERGE CARE OF THE VILLAGES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-775-6428
Mailing Address - Street 1:785 HIGHWAY 466
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6340
Mailing Address - Country:US
Mailing Address - Phone:352-775-6428
Mailing Address - Fax:352-633-1614
Practice Address - Street 1:785 HIGHWAY 466
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-775-6428
Practice Address - Fax:352-633-1614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92040261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1932186061OtherMEDICARE NPI