Healthcare Provider Details

I. General information

NPI: 1427789239
Provider Name (Legal Business Name): SCHUYLER PATRICK HULTMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21110 BISCAYNE BLVD
MIAMI FL
33180-1227
US

IV. Provider business mailing address

2420 SW 34TH AVE
MIAMI FL
33145-3147
US

V. Phone/Fax

Practice location:
  • Phone: 305-727-4247
  • Fax:
Mailing address:
  • Phone: 434-987-4164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT227262
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME163647
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: