Healthcare Provider Details

I. General information

NPI: 1760688196
Provider Name (Legal Business Name): CHARLES ROBERT SCHMIDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 TAMIAMI TRL N SUITE 206
NAPLES FL
34103-3027
US

IV. Provider business mailing address

PO BOX 413012
NAPLES FL
34101-3012
US

V. Phone/Fax

Practice location:
  • Phone: 239-261-1158
  • Fax: 239-261-4232
Mailing address:
  • Phone: 239-261-1158
  • Fax: 239-261-4232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME57167
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: