Provider Demographics
NPI:1336210665
Name:SCHWARTZ, STEPHEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1874 W HILLSBORO BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1420
Mailing Address - Country:US
Mailing Address - Phone:954-421-2900
Mailing Address - Fax:954-421-7100
Practice Address - Street 1:1874 W HILLSBORO BLVD STE F
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1420
Practice Address - Country:US
Practice Address - Phone:954-421-2900
Practice Address - Fax:954-421-7100
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0000678213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAS 5349027OtherFDA
FL1127170001OtherDURABLE GOODS #
FLAS 5349027OtherFDA
FL87265Medicare ID - Type Unspecified