Healthcare Provider Details

I. General information

NPI: 1801250709
Provider Name (Legal Business Name): ALEXANDER MICHAEL SCHRODT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2402 FRIST BLVD STE 204
FORT PIERCE FL
34950-4838
US

IV. Provider business mailing address

4800 ALBERTA AVE
EL PASO TX
79905-2709
US

V. Phone/Fax

Practice location:
  • Phone: 772-462-3939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101274224
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberME149669
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: