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General NPI Number Information
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NPI Number | 1063480069
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Entity Type | Individual
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Provider Name | CARY THOMAS SCHULTZ CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1 SHIRCLIFF WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4748
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Country | US
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Telephone | 904-568-4543
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Fax |
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Provider Business Mailing Address
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Address Line | 507 MAJESTIC EAGLE DR
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City | PONTE VEDRA
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State | FL
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Zip | 32081-0609
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Country | US
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Telephone | 910-546-7634
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 054263
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 054263
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License Number State | FL
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