Basic Information
| Provider Information | |||||||||
| NPI: | 1306809769 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SCHREIBER | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9705 COMMERCE CENTER CT STE 103 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339083767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2394379313 | ||||||||
| FaxNumber: | 8772902563 | ||||||||
| Practice Location | |||||||||
| Address1: | 9705 COMMERCE CENTER CT STE 103 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2394379313 | ||||||||
| FaxNumber: | 8772902563 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2006 | ||||||||
| LastUpdateDate: | 12/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | OS7991 | FL | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 260079000 | 05 | FL | MEDICAID | 49684 | 01 | FL | BCBS | OTHER |