Healthcare Provider Details

I. General information

NPI: 1164535936
Provider Name (Legal Business Name): ALLEN F SCHULTZ D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 04/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 N CONGRESS AVE SUITE 304B
WEST PALM BEACH FL
33407-3282
US

IV. Provider business mailing address

4700 N CONGRESS AVE SUITE 304B
WEST PALM BEACH FL
33407-3282
US

V. Phone/Fax

Practice location:
  • Phone: 561-848-1011
  • Fax: 561-848-9166
Mailing address:
  • Phone: 561-848-1011
  • Fax: 561-848-9166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberOS3284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: