Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | ME90810 | FL |
NPI | 1154363489 |
---|---|
Provider Name | Dr. Kevin Marc Schreiber |
First Address | Sunrise, FL 33323-2865 |
Second Address | Hollywood, FL 33021-5421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 04/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
270627000 | (05) | FL |
48749 | BLUE SHIELD (01) | FL |
I07430 | (02) |