Healthcare Provider Details

I. General information

NPI: 1649350927
Provider Name (Legal Business Name): FM ANTONIETA SCHETTINO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANTONIETA SCHETTINO MD

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 10/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8335 NW 12TH ST
DORAL FL
33126-1841
US

IV. Provider business mailing address

8335 NW 12TH ST
DORAL FL
33126-1841
US

V. Phone/Fax

Practice location:
  • Phone: 786-464-1444
  • Fax: 786-845-8568
Mailing address:
  • Phone: 786-464-1444
  • Fax: 786-845-8568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME80969
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: