Provider Demographics
NPI:1295997302
Name:SCHWARZ, JULIO ESTUARDO (MD)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:ESTUARDO
Last Name:SCHWARZ
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 1:5 GRADY JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-6026
Mailing Address - Country:US
Mailing Address - Phone:912-489-6246
Mailing Address - Fax:912-489-6346
Practice Address - Street 1:5 GRADY JOHNSON RD
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-6026
Practice Address - Country:US
Practice Address - Phone:912-489-6246
Practice Address - Fax:912-489-6346
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN12478207R00000X
GA076574207RC0000X, 207RI0011X
FLME110375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003859800Medicaid
GA003179956AMedicaid
GA003179956AMedicaid