Provider Demographics
NPI:1295924496
Name:PEGGY L SCHNEIDER M.D.
Entity type:Organization
Organization Name:PEGGY L SCHNEIDER M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-736-7969
Mailing Address - Street 1:2623 S SEACREST BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7531
Mailing Address - Country:US
Mailing Address - Phone:561-736-7969
Mailing Address - Fax:561-736-5199
Practice Address - Street 1:2623 S SEACREST BLVD STE 106
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7531
Practice Address - Country:US
Practice Address - Phone:561-736-7969
Practice Address - Fax:561-736-5199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE61845Medicare UPIN
FL10208Medicare PIN