Healthcare Provider Details

I. General information

NPI: 1356366884
Provider Name (Legal Business Name): JASON D SCHULTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 DERBY GLEN DR
ORLANDO FL
32837-8028
US

IV. Provider business mailing address

1901 DERBY GLEN DR
ORLANDO FL
32837-8028
US

V. Phone/Fax

Practice location:
  • Phone: 407-637-1147
  • Fax:
Mailing address:
  • Phone: 407-637-1147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME96405
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME96405
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME96405
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: