Provider Demographics
NPI:1376035683
Name:SCHMIDL, JOSEPH EDWARD (DPM)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EDWARD
Last Name:SCHMIDL
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 1:9250 CORKSCREW RD STE 7
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-3216
Mailing Address - Country:US
Mailing Address - Phone:239-949-2121
Mailing Address - Fax:
Practice Address - Street 1:9250 CORKSCREW RD STE 7
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-3216
Practice Address - Country:US
Practice Address - Phone:239-949-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-01
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4534213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist