Healthcare Provider Details

I. General information

NPI: 1073671434
Provider Name (Legal Business Name): ERIC MAHLON-PAUL SCHEUFLER D.M.D, M.D. P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 BUSINESS CENTRE DR SUITE 210
MIRAMAR BEACH FL
32550-6920
US

IV. Provider business mailing address

42 BUSINESS CENTRE DR SUITE 210
MIRAMAR BEACH FL
32550-6920
US

V. Phone/Fax

Practice location:
  • Phone: 850-269-7550
  • Fax: 850-269-7552
Mailing address:
  • Phone: 850-269-7550
  • Fax: 850-269-7552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN 15593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: