Provider Demographics
NPI:1215920277
Name:SCHAUDER, ELLIS H (DC)
Entity type:Individual
Prefix:DR
First Name:ELLIS
Middle Name:H
Last Name:SCHAUDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S GOLDENROD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8123
Mailing Address - Country:US
Mailing Address - Phone:407-275-6700
Mailing Address - Fax:407-275-8867
Practice Address - Street 1:501 S GOLDENROD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8123
Practice Address - Country:US
Practice Address - Phone:407-275-6700
Practice Address - Fax:407-275-8867
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004639111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT84472Medicare UPIN
FL70521Medicare ID - Type Unspecified