Provider Demographics
NPI:1912147638
Name:SCHWARTZ, DANIEL JACOB (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:JACOB
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 FIORI DR
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-9522
Mailing Address - Country:US
Mailing Address - Phone:850-276-0065
Mailing Address - Fax:
Practice Address - Street 1:6025 FIORI DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-9522
Practice Address - Country:US
Practice Address - Phone:850-276-0065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-21
Last Update Date:2012-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE56465163WC0200X
CA085330367500000X
CA748618163W00000X
FL085330367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse