Healthcare Provider Details

I. General information

NPI: 1265593982
Provider Name (Legal Business Name): KENNETH R SCHROER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3804
US

IV. Provider business mailing address

1329 SW 16TH ST RM 2232
GAINESVILLE FL
32608-1128
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0301
  • Fax:
Mailing address:
  • Phone: 352-559-5051
  • Fax: 352-265-8018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberME0044200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: