Basic Information
| Provider Information | |||||||||
| NPI: | 1194027409 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEIL SCHULTZ, MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2825 N STATE ROAD 7 | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MARGATE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330635737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549734555 | ||||||||
| FaxNumber: | 9549707908 | ||||||||
| Practice Location | |||||||||
| Address1: | 2825 N STATE ROAD 7 | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MARGATE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330635737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549734555 | ||||||||
| FaxNumber: | 9549707908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2010 | ||||||||
| LastUpdateDate: | 11/19/2010 | ||||||||
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| AuthorizedOfficialLastName: | SCHULTZ | ||||||||
| AuthorizedOfficialFirstName: | NEIL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 9549734555 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | ME 33024 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 048113100 | 05 | FL | MEDICAID |