Healthcare Provider Details

I. General information

NPI: 1851358287
Provider Name (Legal Business Name): JUDITH L SCHAECHTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 01/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 NW 12 AVE M851
MIAMI FL
33101-6960
US

IV. Provider business mailing address

1601 NW 12 AVE M851
MIAMI FL
33101-6960
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-4029
  • Fax: 305-243-8470
Mailing address:
  • Phone: 305-243-4029
  • Fax: 305-243-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License NumberME70440
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME70440
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberME70440
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: