Healthcare Provider Details

I. General information

NPI: 1801214465
Provider Name (Legal Business Name): SCHIERLINGER PODIATRY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S RIDGEWOOD AVE SUITE 1 & 2
EDGEWATER FL
32132-1946
US

IV. Provider business mailing address

201 S RIDGEWOOD AVE SUITE 1 & 2
EDGEWATER FL
32132-1946
US

V. Phone/Fax

Practice location:
  • Phone: 386-423-9573
  • Fax: 386-423-6823
Mailing address:
  • Phone: 386-423-9573
  • Fax: 386-423-6823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO0001828
License Number StateFL

VIII. Authorized Official

Name: KURT A. SCHIERLINGER
Title or Position: OWNER
Credential: D.P.M.
Phone: 386-423-9573