Provider Demographics
NPI:1013914720
Name:SCHWARTZ, KERRY M (MD)
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:M
Last Name:SCHWARTZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 READING DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6730
Mailing Address - Country:US
Mailing Address - Phone:407-848-4022
Mailing Address - Fax:
Practice Address - Street 1:1100 WILFORD HALL LOOP
Practice Address - Street 2:
Practice Address - City:JBSA LACKLAND
Practice Address - State:TX
Practice Address - Zip Code:78236-5638
Practice Address - Country:US
Practice Address - Phone:407-848-4022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036337207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL212319OtherAVMED
FL4008556OtherAETNA
FL47355OtherBCBS
FL060019791OtherRRR
FL11581OtherFHHS
FL2659048OtherCIGNA
FL11581OtherFHHS
D55022Medicare UPIN