Basic Information
Provider Information
NPI: 1659320042
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHNIER
FirstName: MARTIN
MiddleName: STEVEN
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 39200 HOOKER HWY
Address2: LAKESIDE MEDICAL CENTER
City: BELLE GLADE
State: FL
PostalCode: 334305368
CountryCode: US
TelephoneNumber: 5619966571
FaxNumber: 5619968930
Practice Location
Address1: 39200 HOOKER HWY
Address2: LAKESIDE MEDICAL CENTER
City: BELLE GLADE
State: FL
PostalCode: 334305368
CountryCode: US
TelephoneNumber: 5619966571
FaxNumber: 5619968930
Other Information
ProviderEnumerationDate: 05/10/2006
LastUpdateDate: 02/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207QG0300XOS-0007221FLY Allopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine

No ID Information.


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