MEDICARE: MRS. LISA SCHNEIDER

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	363LF0000X	Family Nurse Practitioner	APRN11008209	FL

General Provider Information

NPI Number	:	1194334953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA SCHNEIDER

Provider Business Mailing Address
First Line	:	1420 ALPHA CT N
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6805
Country	:	US
Telephone Number	:	561-339-3391
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 FOREST HILL BLVD STE 201
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-6059
Country	:	US
Telephone Number	:	561-337-4033
Fax Number	:	567-337-4080

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

Provider Enumeration Date	:	07/28/2020
Last Update Date	:	03/07/2023

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