Provider Demographics
NPI:1013170117
Name:SCHUETZ, CHRISTIAN R (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:R
Last Name:SCHUETZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 FRIST BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4838
Mailing Address - Country:US
Mailing Address - Phone:772-462-3939
Mailing Address - Fax:
Practice Address - Street 1:2042 FRIST BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-3603
Practice Address - Country:US
Practice Address - Phone:772-462-3939
Practice Address - Fax:772-462-3938
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103118208600000X, 2086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000658900Medicaid
FL17023OtherBLUE CROSS BLUE SHIELD
FLBL265XMedicare PIN