Basic Information
| Provider Information | |||||||||
| NPI: | 1184845323 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHWARZ | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | JACOB | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1613 HARRISON PKWY | ||||||||
| Address2: | |||||||||
| City: | SUNRISE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333232896 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548382048 | ||||||||
| FaxNumber: | 9548580103 | ||||||||
| Practice Location | |||||||||
| Address1: | 3390 N CAMPBELL AVE | ||||||||
| Address2: | STE 110 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857192380 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207957650 | ||||||||
| FaxNumber: | 5203251622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 07/01/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | OS10724 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 20A13369 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 229917 | 05 | AZ | MEDICAID |