Provider Demographics
NPI:1649278193
Name:SCHROEDER, FREDERICK J (MD)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:J
Last Name:SCHROEDER
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 1:200 W GORE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1035
Mailing Address - Country:US
Mailing Address - Phone:407-841-7723
Mailing Address - Fax:407-841-2479
Practice Address - Street 1:200 W GORE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1035
Practice Address - Country:US
Practice Address - Phone:407-841-7723
Practice Address - Fax:407-841-2479
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0029121207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D55020Medicare UPIN
47345Medicare ID - Type Unspecified