Provider Demographics
NPI:1649042847
Name:SCHWARZ, MADISON
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:SCHWARZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8202 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6695
Mailing Address - Country:US
Mailing Address - Phone:727-819-1610
Mailing Address - Fax:727-868-0596
Practice Address - Street 1:8202 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6695
Practice Address - Country:US
Practice Address - Phone:727-819-1610
Practice Address - Fax:727-868-0596
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11028838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily