Provider Demographics
NPI:1023168739
Name:SCHOU, MICHAEL JOHAN (MD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOHAN
Last Name:SCHOU
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 1:1100 NW 95 ST
Mailing Address - Street 2:2ND FLOOR ADVANCE PAIN MANAGEMENT OF FLORIDA INC
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-2098
Mailing Address - Country:US
Mailing Address - Phone:305-694-3775
Mailing Address - Fax:305-694-3678
Practice Address - Street 1:1100 NW 95 ST
Practice Address - Street 2:2ND FLOOR ADVANCE PAIN MANAGEMENT OF FLORIDA INC
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-2098
Practice Address - Country:US
Practice Address - Phone:305-694-3775
Practice Address - Fax:305-694-3678
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38962207L00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068777400Medicaid
FL95977Medicare ID - Type Unspecified
D63684Medicare UPIN