Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | FL2348 | FL |
NPI | 1497792774 |
---|---|
Provider Name | Mr. Mark D. Schafe |
First Address | Ft. Myers, FL 33912 |
Second Address | Ft. Myers, FL 33912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 15/05/2012 |