Healthcare Provider Details

I. General information

NPI: 1881057933
Provider Name (Legal Business Name): WESTIN SCHMIDT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4435 13TH ST
SAINT CLOUD FL
34769-6724
US

IV. Provider business mailing address

4435 13TH ST
SAINT CLOUD FL
34769-6724
US

V. Phone/Fax

Practice location:
  • Phone: 407-957-9995
  • Fax:
Mailing address:
  • Phone: 407-957-9995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: