Healthcare Provider Details

I. General information

NPI: 1093877599
Provider Name (Legal Business Name): JASON SCHULMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 07/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

IV. Provider business mailing address

3801 BISCAYNE BLVD STE 300
MIAMI FL
33137-9800
US

V. Phone/Fax

Practice location:
  • Phone: 305-571-0620
  • Fax: 305-576-0919
Mailing address:
  • Phone: 305-571-0620
  • Fax: 305-576-0919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0074883
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: