Provider Demographics
NPI:1396760104
Name:ROBERT I SCHNIPPER MD PA
Entity type:Organization
Organization Name:ROBERT I SCHNIPPER MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:G
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-355-5555
Mailing Address - Street 1:2001 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-3703
Mailing Address - Country:US
Mailing Address - Phone:904-355-5555
Mailing Address - Fax:904-355-9966
Practice Address - Street 1:2001 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204
Practice Address - Country:US
Practice Address - Phone:904-355-5555
Practice Address - Fax:904-355-9966
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT I SCHNIPPER MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-13
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME19517207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCK0877OtherRRMEDICARE
FL373611300Medicaid
FL1142310001Medicare NSC
FL373611300Medicaid
FL1588667695Medicare NSC
FLD58172Medicare UPIN
FL1952304032Medicare NSC