Healthcare Provider Details

I. General information

NPI: 1285685677
Provider Name (Legal Business Name): ENRIQUE GERARDO UMPIERRE SCHUCK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 N GOLDENROD RD STE 103
WINTER PARK FL
32792-8611
US

IV. Provider business mailing address

4243 NW FEDERAL HWY
JENSEN BEACH FL
34957-3600
US

V. Phone/Fax

Practice location:
  • Phone: 800-735-1178
  • Fax: 772-223-6354
Mailing address:
  • Phone: 800-735-1178
  • Fax: 772-223-6354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME81176
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: