Healthcare Provider Details

I. General information

NPI: 1679573869
Provider Name (Legal Business Name): MARC STEVEN SCHNEIDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12751 S CLEVELAND AVE SUITE 102
FORT MYERS FL
33907-7732
US

IV. Provider business mailing address

12751 S CLEVELAND AVE SUITE 102
FORT MYERS FL
33907-7732
US

V. Phone/Fax

Practice location:
  • Phone: 239-277-9999
  • Fax: 239-277-3998
Mailing address:
  • Phone: 239-277-9999
  • Fax: 239-277-3998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License NumberME0050478
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: