Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC2388 | FL |
NPI | 1003982851 |
---|---|
Provider Name | Dr. Warren S. Schmitt |
First Address | Eustis, FL 32727-2082 |
Second Address | Titusville, FL 32780-5492 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 29/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
078849000 | (05) | FL |
20143 | BCBS OF FL PROVIDER # (01) | FL |
4322801 | AETNA PROVIDER NUMBER (01) | FL |
U27682 | (02) | FL |