Basic Information
| Provider Information | |||||||||
| NPI: | 1619489648 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHNEIDER | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2804 N UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330655010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542278040 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2804 N UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330655010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9542278040 | ||||||||
| FaxNumber: | 9542278046 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2017 | ||||||||
| LastUpdateDate: | 10/31/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | PT16731 | DC | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.