Provider Demographics
NPI:1649350927
Name:SCHETTINO, FM ANTONIETA (MD)
Entity type:Individual
Prefix:
First Name:FM
Middle Name:ANTONIETA
Last Name:SCHETTINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANTONIETA
Other - Middle Name:
Other - Last Name:SCHETTINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8335 NW 12TH ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1841
Mailing Address - Country:US
Mailing Address - Phone:786-464-1444
Mailing Address - Fax:786-845-8568
Practice Address - Street 1:8335 NW 12TH ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33126-1841
Practice Address - Country:US
Practice Address - Phone:786-464-1444
Practice Address - Fax:786-845-8568
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2017-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80969208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP3049221OtherFIRST HEALTH SOUTH CARE
FL175475OtherJHM
FL2139404OtherCIGNA
FL218046OtherAMERIGROUP
FL218320OtherSTAYWELL WELL CARE
FL279203OtherAVMED
FL259975900Medicaid
FL107954OtherHUMANA
FL7133566OtherAETNA
FL1200570OtherUNITED
FL40100OtherNHP
FL78725OtherBLUE CROSS BLUE SHIELD
FL21201297964OtherBEECH STREET