MEDICARE: JOHN ANTHONY SCHWERER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN0010628	FL

General Provider Information

NPI Number	:	1184817934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ANTHONY SCHWERER

Provider Business Mailing Address
First Line	:	4634 S 25TH ST
Second Line	:
City	:	FT PIERCE
State	:	FL
Zip	:	34981
Country	:	US
Telephone Number	:	772-461-7323
Fax Number	:	772-464-2859

Provider Business Practice Location Address
First Line	:	4634 S 25TH ST
Second Line	:
City	:	FT PIERCE
State	:	FL
Zip	:	34981
Country	:	US
Telephone Number	:	772-461-7323
Fax Number	:	772-464-2859

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	08/24/2007

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