Healthcare Provider Details

I. General information

NPI: 1326115932
Provider Name (Legal Business Name): JENNIFER SCHMIDT MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 WEST MICHIGAN STREET
ORLANDO FL
32805-6203
US

IV. Provider business mailing address

1206 W NEW HAMPSHIRE ST
ORLANDO FL
32804-5759
US

V. Phone/Fax

Practice location:
  • Phone: 407-317-7430
  • Fax: 407-648-4150
Mailing address:
  • Phone: 904-318-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT21401
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberPT21401
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: