Provider Demographics
NPI:1205156247
Name:SCHMIDT, GERALD ERNST (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:ERNST
Last Name:SCHMIDT
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 1:3011 NE 46TH ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5315
Mailing Address - Country:US
Mailing Address - Phone:970-819-1446
Mailing Address - Fax:
Practice Address - Street 1:3848 FAU BLVD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6437
Practice Address - Country:US
Practice Address - Phone:561-362-9191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME347582085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology