Healthcare Provider Details

I. General information

NPI: 1144495532
Provider Name (Legal Business Name): LARRY E. SCHUTZ, PHD, ABPP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 VINELAND RD SUITE 116
ORLANDO FL
32819-7829
US

IV. Provider business mailing address

6703 CACTUS CT
ORLANDO FL
32819-4501
US

V. Phone/Fax

Practice location:
  • Phone: 407-351-4962
  • Fax: 407-345-9765
Mailing address:
  • Phone: 407-351-4962
  • Fax: 407-345-9765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: LARRY E SCHUTZ
Title or Position: MANAGING PARTNER
Credential: PHD
Phone: 407-351-4962