Healthcare Provider Details

I. General information

NPI: 1972511475
Provider Name (Legal Business Name): TODD D SCHWARTZ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW 82ND AVE STE 103
PLANTATION FL
33324-1853
US

IV. Provider business mailing address

1130 TEN ROD RD D201
NORTH KINGSTOWN RI
02852-4161
US

V. Phone/Fax

Practice location:
  • Phone: 954-693-0004
  • Fax: 954-693-4345
Mailing address:
  • Phone: 401-295-8655
  • Fax: 401-295-8335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberOS5762
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: